本文關(guān)鍵詞：真武湯合五苓散治療糖尿病腎病水腫的臨床研究　出處：《廣州中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 真武湯與五苓散合方 糖尿病腎病水腫 陽(yáng)虛水濕瘀阻

【摘要】：目的:本研究通過對(duì)60例陽(yáng)虛水濕瘀阻型的糖尿病腎臟疾病水腫的患者進(jìn)行臨床治療與觀察,著重從中醫(yī)治療方面入手,觀察在西醫(yī)基礎(chǔ)治療上靈活運(yùn)用真武湯與五苓散合方加減治療糖尿病腎病引起的雙下肢水腫的臨床療效,從而為糖尿病腎病的病證結(jié)合治療提供臨床依據(jù),豐富和拓展糖尿病腎病患者水腫方面的治療方法,為臨床研究開拓新的思路。方法:選取2016年4月至2017年1月期間在我院門診及住院部就診的糖尿病腎臟疾病以雙下肢水腫為主的(陽(yáng)虛水濕瘀阻型)患者60例,在嚴(yán)格的前瞻性雙盲隨機(jī)對(duì)照研究的基礎(chǔ)上平均分為兩組(治療組和對(duì)照組),每組各30例。對(duì)照組在降壓、降脂、降糖等基礎(chǔ)西藥治療基礎(chǔ)上給予呋塞米片口服40mg,Bid;治療組在西醫(yī)基礎(chǔ)治療上給予真武湯與五苓散合方加減,療程均為2周,治療前后分別對(duì)患者的安全性指標(biāo)及實(shí)驗(yàn)室指標(biāo)進(jìn)行1次記錄,對(duì)患者中醫(yī)癥候、水腫程度分別進(jìn)行判斷,做好記錄,待觀察結(jié)束用后SPSS22.0統(tǒng)計(jì)軟件對(duì)所記錄的各項(xiàng)指標(biāo)進(jìn)行統(tǒng)計(jì)學(xué)分析、處理。在治療的2周內(nèi)對(duì)患者曾出現(xiàn)的不良反應(yīng)、異常指標(biāo)做好記錄。成果:研究結(jié)果顯示,治療組總有效率為83.3%,對(duì)照組的總有效率60.0%,中藥治療組的療效要顯著優(yōu)于對(duì)照組。治療前后兩組的中醫(yī)癥候積分上(P0.05)因此二者存在差異,且治療組優(yōu)于對(duì)照組。治療前后兩組患者的實(shí)驗(yàn)室指標(biāo)方面,經(jīng)治療后患者空腹及餐后血糖水平、24h尿蛋白定量、血肌酐、尿素氮較治療前均有所下降,治療組下降程度更優(yōu)。兩組的安全性指標(biāo)方面均沒有出現(xiàn)明顯不良反應(yīng)及異常指標(biāo)。結(jié)論:在西醫(yī)基礎(chǔ)治療上靈活用真武湯五苓散合方加減治療早期糖尿病腎病引起水腫可明顯改善患者的臨床癥狀及中醫(yī)癥候表現(xiàn)(肢體浮腫、畏寒、小便不利、少氣懶言等),且能明顯提高糖尿病腎病以雙下肢水腫為主的(陽(yáng)虛水濕瘀阻型)患者的臨床療效,還能降低患者的空腹血糖、餐后2h血糖、24h尿蛋白定量、BUN、Scr等實(shí)驗(yàn)室指標(biāo),表明靈活運(yùn)用經(jīng)方辨證治療陽(yáng)虛水濕瘀阻型早期糖尿病腎病雙下肢有明顯的療效且安全性較高,暫時(shí)取得了比較滿意的效果,今后仍需進(jìn)一步的補(bǔ)充、證實(shí)與完善。
[Abstract]:Objective: to study the clinical treatment and observation of 60 cases of diabetic renal disease edema caused by Yang deficiency and water dampness and stasis, and to focus on the treatment of traditional Chinese medicine (TCM). To observe the clinical efficacy of Zhenwu decoction and Wuling Powder decoction in the treatment of edema of both lower limbs caused by diabetic nephropathy, and to provide the clinical basis for the combined treatment of disease and syndrome of diabetic nephropathy. Enrich and expand the treatment of diabetic nephropathy patients with edema. Methods: from April 2016 to January 2017, diabetic kidney diseases in outpatient and inpatient departments of our hospital were mainly caused by edema of the lower extremity (. There were 60 patients with Yang deficiency and water dampness and stagnation. On the basis of a strict prospective double-blind randomized controlled study, the average was divided into two groups (treatment group and control group, 30 cases in each group. On the basis of treatment of hypoglycemic and other basic western medicine, furosemide tablets were given orally for 40mg Bididin; The treatment group was treated with Zhenwu decoction and Wuling Powder decoction for 2 weeks. Before and after treatment, the safety index and laboratory index of patients were recorded for 1 time, and the symptoms of TCM were recorded. The edematous degree was judged and recorded, and the SPSS22.0 statistical software was used to statistically analyze the indexes after observation. Treatment. In the treatment of 2 weeks of adverse reactions, abnormal indicators to make a good record. Results: the results of the study showed that the total effective rate of the treatment group was 83.3 percent, the total effective rate of the control group was 60.0%. Traditional Chinese medicine treatment group is significantly better than the control group. The two groups before and after treatment of traditional Chinese medicine symptoms score P0.05) so there is a difference between the two groups. And the treatment group is better than the control group. Before and after the treatment of the two groups of patients' laboratory indicators, after the treatment of fasting and postprandial blood glucose levels of 24 hours urine protein quantitative, blood creatinine, urea nitrogen compared with the treatment before and after treatment have decreased. There were no significant adverse reactions and abnormal indexes in both groups. Conclusion:. The flexible use of Zhenwu Tang Wuling Powder decoction in the treatment of edema caused by early diabetic nephropathy can obviously improve the clinical symptoms and symptoms of traditional Chinese medicine (. Puffy limbs. It can obviously improve the clinical efficacy of diabetic nephropathy with edema of both lower extremities (Yang deficiency and water dampness stasis type) and can also reduce the fasting blood glucose of the patients. 2 h postprandial blood glucose and 24 h urinary protein were measured by BUNN SCR and other laboratory indexes. The results indicated that the flexible use of Meridian prescription in treating early diabetic nephropathy with Yang deficiency and water dampness stasis had obvious curative effect and high safety, and achieved satisfactory results temporarily, which still needed to be further supplemented in the future. Verification and perfection.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

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