补肾活血汤联合西药治疗气阴两虚型糖尿病肾病Ⅳ期水肿随机平行对照研究

Study of Random and Parallel and Control of Bushen Huoxue Tang in Treatment of Combined with Western Medicine in Edema of Diabetic Nephropathy IV Edema with Qi and Yin Deficiency

[目的]观察补肾活血汤联合西药治疗气阴两虚型糖尿病肾病IV期水肿疗效。[方法]使用随机平行对照方法,将72例住院患者按随机数字表方法随机分为两组,均常规治疗,控制饮食(低盐、优质低蛋白糖尿病饮食);控制血糖(胰岛素控制血糖:空腹血糖≤7.0retool/L,餐后2h血糖≤10.0retool/L,糖化血红蛋白<7.0%);控制血压(<130/80mmHg)。对照组36例洛汀新10mg,2次/d。治疗组36例补肾活血汤(黄芪30g,生地黄15g,山药20g,山茱萸15g,茯苓30g,泽泻、丹皮、当归、川芎各15g,赤芍20g,白术10g,泽兰15g,大腹皮20g,车前草15g)水煎,1剂/d。观测中医症状积分、生化指标。30d为1疗程,连续治疗1疗程,随访60d,判定疗效。[结果]中医症状积分两组均有降低(P<0.01),治疗组优于对照组(P<0.05);水肿均有消退,治疗组优于对照组(P<0.01);APTT、PT、FIB治疗组有改善(P<0.05),对照组均无明显改善(P>0.05),治疗组优于对照组(P<0.05);CHOL、TG、UP治疗组均明显减少(P<0.01,P<0.05),对照组无显著变化(P>0.05),组间差异显著(P<0.05,P<0.01)。[结论]补肾活血汤可改善糖尿病肾病的高凝状态、调节血液流变学、改善脂代谢异常,对糖尿病肾病性水肿具有较好的治疗作用,实现对肾脏的保护作用。

[ Objective ] To observe the clinical effect of Bushen Huoxue Tang combined with western medicine in edema of diabetic nephropathy IV edema with Qi and Yin deficiency. The use of random and parallel and control method. [Method]72 cases of hospitalized patients were randomly divided into two groups ,Ac- cording to the random number table. 72 cases were treted by conventional treatment. Diet control （Low salt and small number of high - quality protein） , control of blood glucose （ The use of insulin to control blood sug- ar. Fasting blood sugar~〈7.0retool/L, 2h postprandial blood glucoses〈 10.0retool/L, Glycated hemoglobin 〈 7.0% ） ,control of blood pressure（ 〈 130/80mmHg）. Control group （C - group） were treated by Luo Tingxin 10rag 2/d and Treatment group （T- group） by Bushen Huoxue Tang （Huangqi30g, Shengdihuangl5g, Shan- yao20g, Shanzhuyul5g, Fuling30g, Zexiel5g, DanpinlSg, Dangguil5g, Chuanxiongl5g, Chishao20g, Baizhul0g, ZelanlSg, Dafupi20g, Cheqiancaol5g. ） , Water decoction , Dailylagent. Observation of TCM symp- tom score and biochemical index. 30d 1treatment. Continuousl course of treatment, Follow up 60d. The eval- uation of curative effect after the end. [ Result~ The two groups were lower symptom score（ P 〈 0.01 ）and ede- ma have subsided. In treatment group than in control group （P 〈 0.05 ）. For At^I＂ and PT and FIB, the treat- ment group improved （ P 〈 0.05 ） , the control group showed no significant improvement （ P 〉 0.05 ） , in treatment group than in control group（ P 〈 0.05 ）. For CHOL, TG, UP treatment group were obviously de- creased the control group showed no significant improvement （ P 〉 0.05 ） , in treatment group than in control group （ P 〈 0. 05 ）. Differences among groups were significan （ P 〈 0. 05, P 〈 0. 01 ）. [ Conclusion ] Bushen Huoxue Tang n can improve Hypercoagulable state and Lipid metabolism disorder, regulation of blood rheology. Bushen Huoxue Tang on diabetic nephrotic edema with good therapeutic effect. Implementation of protec- tion of renal function.