自拟温阳消浊汤加减改善脾肾阳虚型消渴病胃肠功能障碍的临床研究

Clinical Study of Warming Yang and Eliminating Turbidity Decoction Improving Spleen Kidney Yang Deficiency Xiaoke Disease of Gastrointestinal Dysfunction

目的:探讨温阳消浊汤加减改善脾肾阳虚证型消渴病胃肠功能障碍的临床疗效。方法:选择脾肾阳虚证型消渴病78例,按数字法随机分为实验组和对照组,每组各39例,对照组给予内科常规治疗,实验组在内科常规治疗基础上加用温阳消浊汤加减治疗,内科常规治疗包括胰岛素注射液皮下注射,盐酸二甲双胍口服,1片/次(0.5 g),1次/d,根据血糖给予个体化计量,两组均治疗4周为1个疗程,对患者治疗前后实验室指标以及症候群等变化进行观察。结果:1治疗后两组餐后血糖、空腹血糖、糖化血红蛋白、尿糖较治疗前均降低,但组间比较无显著性差异(P>0.05);2实验组血清肌酐(Screw)、内生肌酐清除率(Ccr)、肾血尿素氮(BUN)、小球滤过率(GFR)改善程度明显优于对照组(P<0.05)。3实验组患者胃肠道功能的改善情况显著优于仅用西药治疗的对照组患者,两组相比较具有显著性差异(P<0.05)。4实验组总有效率为89.66%,对照组总有效率为58.62%,实验组疗效显著优于对照组(χ2=5.682,P<0.05)。结论:温阳消浊汤加减能改善脾肾阳虚证型消渴病胃肠功能,并且对脾肾阳虚证型消渴病患者的肾功能也有明显的改善,临床效果明显优于单纯西药治疗,可以在临床推广应用。

Objective ： To investigate the clinical efficacy of Warming Yang and Eliminating Turbidity Decoction impro- ving spleen kidney yang deficiency type diabetes gastrointestinal dysfunction. Methods ：78 cases of spleen kidney yang de- ficiency type diabetes, according to the number were randomly divided into experimental group and control group,39 cases in each group. The control group was given conventional treatment of internal medicine. The experimental group based on the conventional treatment added Warming Yang and Eliminating Turbidity Decoction. The conventional treatment inclu- ding insulin injection subcutaneously injection, oral administration of metformin hydrochloride, 1 tablet/time （0. 5 g）, 1/ d glucose, according to give individual measurement. Two groups were treated for 4 weeks for 1 course. The changes of la- boratory indexes and syndrome patients before and after treatment were observed. Results：After the treatment, two groups postprandial blood glucose,fasting blood glucose, glycosylated hemoglobin, urine were decreased, but there was no signifi- cant difference between groups （ P 〉 0.05 ） ; the experimental group Scr, BUN, GFR, Ccr improved significantly better than those of the control group （ P 〈 0.05 ）. The situation of the patients in the experimental group was significantly better than that of gastrointestinal function only with western medicine in the treatment of the patients in the control group. The two groups had significant difference （ P 〈 0.05 ）. The experiment group total effective rate was 89.66% and control group total effective rate was 58.62%. The curative effect of experimental group was significantly better than the control group （ χ2 = 5. 682 ,P 〈 0. 05 ）. Conclusion ：The Warming Yang and Eliminating Turbidity Decoction can improve gastrointestinal spleen kidney yang deficiency syndrome type of diabetes and renal function. The clinical effect is better than pure western medicine therapy and it can be applied in clinic.