加味真武汤治疗Ⅳ期脾肾阳虚型糖尿病肾病临床研究

Evaluation on Clinical Therapeutic Effects of Modified Zhenwu Decoction in TreatingⅣ Stage Diabetic Nephropathy Due to Yang Deficiency of Spleen-kidney

目的探讨加味真武汤治疗Ⅳ期脾肾阳虚型糖尿病肾病（DN）的临床疗效。方法将2014年1月-2015年6月130例Ⅳ期DN患者随机分为研究组和对照组各65例,均给予常规治疗,研究组加服加味真武汤,疗程1月。比较2组治疗前后的中医证候积分、空腹血糖（FPG）、尿蛋白定量、血清肌酐（Scr）、肌酐清除率（Ccr）、收缩压（SBP）和舒张压（DBP）的改变情况,评价2组的临床疗效和安全性。结果与对照组比较,研究组治疗后的中医证候积分、FPG、尿蛋白定量、Scr、Ccr、SBP和DBP降低更为明显,差异均具有统计学意义（P〈0.05-0.01）。研究组总有效率为90.77%,明显高于对照组的67.69%,P〈0.05。2组治疗期间均未见严重的不良反应。结论在常规治疗基础上给予加味真武汤,能明显改善Ⅳ期脾肾阳虚型DN患者的临床症状,改善肾功能,且无副作用。

OBJECTIVE To explore the clinical therapeutic effects of Jiawei Zhenwu Decoction in treating IV stage diabetic nephropathy（DN）due to yang deficiency of spleen-kidney.METHODS 130 cases with DN at stageⅣcollected from January,2014 to June,2015 were randomly divided into study group and control group,with 65 cases in each group.Conventional therapy were applied to both groups and based on this,patients in the study group were further given Modified Zhenwu Decoction.After the treatment for one month,changes of TCM syndrome scores,fasting blood-glucose（FPG）,urine protein excretion,serum creatinine（Scr）,creatinine clearance rate（Ccr）,systolic blood pressure（SBP）and diastolic blood pressure（DBP）before and after treatment were observed and comparision were made between these two groups to evaluate the clinical efficacy and safety.RESULTS Compared to the control group,there were more evident declines of TCM syndrome scores,FPG,urine protein excretion,Scr,Ccr,SBP and DBP in the study group after treatment,with statistical differences（P〈0.05）.The total effective rate of study group was 90.77%,which was much higher than that of 67.69%in the control group,and there were statistical differences between two groups（P〈0.05）.No serious side effects were noticed during the treatment in both groups.CONCULSION Conventional therapy plus Modified Zhenwu Decoction can evidently improve clinical symptoms and kidney function of patients with IV stage DN due to yang deficiency of spleen-kidney,with no side effects.