祛痰通络汤治疗痰瘀阻络型糖尿病肾病临床观察

Clinical Observation of Diabetic Nephropathy due to Phlegm and Stasis Blocking Meridians Treated with QutanTongluo Decoction

目的观察祛痰通络汤治疗痰瘀阻络型糖尿病肾病（DN）Ⅲ～Ⅳ期的临床疗效。方法将64例患者随机分为对照组和治疗组各32例。对照组给予低盐、低脂、优质低蛋白糖尿病饮食，单纯口服降糖药或合用胰岛素控制血糖，配合降压、降脂治疗。治疗组在此基础上口服祛痰通络汤，每日1剂，分早晚2次服用。两组均连续治疗2个月。结果两组患者治疗后24h尿蛋白定量、肾功能、糖化血红蛋白、血脂较治疗前均有改善（P〈0．05）；其中治疗组中医症状积分、24h尿蛋白定量、血脂较对照组改善更为明显（P〈0．05）；临床疗效比较，治疗组显效率优于对照组（P〈0．05）。结论祛痰通络汤能降低痰瘀阻络型糖尿病肾病Ⅲ～Ⅳ患者尿蛋白，对其肾功能、血脂及临床症状均有改善作用。

Objective To observe the clinical efficacy on diabetic nephropathy（DN） due to phlegm and stasis blocking meridians at Ⅲ - Ⅳ stage treated with QutanTongluo Decoction. Methods Sixty - four patients were randomized into a control group and a treatment group, 32 cases in each one. In the control group, the diets of low salt,low fat and low protein of high quality were required. Additionally, the hypoglyce-mic drug was prescribed for oral administration. Or, insulin was combined to control blood glucose. The anti - hypertensive and lipid - lowering therapy was applied in combination. In the treatment group, on the basis of the control group, QutanTongluo Decoction was supplemented for oral administration, 1 dose a day,taken twice sep- arately in the morning and evening. The treatment was given continuously for 2 months in two groups. Results After treatment,the levels of 24 h urinary protein,renal function, glycosylated hemoglobin and blood lipid were reduced as compared with those before treatment for the patients in the two groups （ P 〈 0.05 ）. The improve-ments in Chinese medicine symptom score, 24 h urinary protein and blood lipid in the treatment group were more remarkable than those in the control group（P 〈0.05）. In comparison of clinical efficacy,the remarkably effective rate in the treatment group was better than that in the control group（ P 〈 0.05 ）. Conclusion Qutan- Tongluo Decoction reduces urinary protein and achieves the improvements in renal function, blood lipid and clinical symptoms of DN due to phlegm and stasis blocking meridians at Ⅲ-Ⅳ stage.