發(fā)布時(shí)間：2018-01-03 06:39

  本文關(guān)鍵詞：益氣養(yǎng)陰清利祛風(fēng)化瘀法治療糖尿病腎�、羝诘呐R床觀察　出處：《南京中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 糖尿病腎病Ⅳ期 益氣養(yǎng)陰、清利祛風(fēng)化瘀法 氣陰兩虛濕瘀型

【摘要】：目的：觀察和驗(yàn)證老師在臨床實(shí)踐中總結(jié)的益氣養(yǎng)陰清利祛風(fēng)化瘀法治療糖尿病腎病(Diabetic nephropathy, DN) IV期的臨床療效。方法：查閱有關(guān)文獻(xiàn),收集、挖掘有關(guān)DN的中西醫(yī)病因病機(jī),整理其主要治則治法及臨床已獲得的成效,在此基礎(chǔ)上,總結(jié)和分析益氣養(yǎng)陰清利祛風(fēng)化瘀法治療DNIV期患者證屬氣陰兩虛濕瘀證的理法方藥之間的特點(diǎn),并對(duì)其療效進(jìn)行觀察。臨床觀察病例選擇符合條件的江蘇省中醫(yī)院腎內(nèi)科門診及住院病人60例,隨機(jī)分為治療組和對(duì)照組,對(duì)照組給予西醫(yī)常規(guī)治療,治療組在此基礎(chǔ)上加用益氣養(yǎng)陰清利祛風(fēng)化瘀方：生黃芪30g,淮山藥10g,山萸肉15g,生地黃12g,京玄參10g,天花粉20g,玉米須15g,細(xì)石韋30g,青風(fēng)藤30g,晚蠶沙20g,鬼箭羽20g,紫丹參15g�？梢暡∏殡S癥加減。每日1劑,水煎兩遍,取汁400m1,分早晚2次溫服。療程為12周。觀察治療前后中醫(yī)癥狀積分、U-TP、FPG、Scr, BUN、UA、Alb、Hb、ALT、AST的變化情況,并進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果：治療組總有效率為83.3%,中醫(yī)證候改善總有效率為86.7%；對(duì)照組總有效率為70%,中醫(yī)證候改善總有效率為73.4%。組內(nèi)比較：兩組U-TP、FPG、Scr、BUN經(jīng)過治療后均有下降(P0.01)；治療組UA治療后改善明顯(P0.01),在對(duì)照組治療后無明顯改善；兩組Hb、Alb、ALT、AST治療后均無明顯變化。組間比較：在改善U-TP、FPG、Scr,BUN方而,治療組明顯優(yōu)于對(duì)照組(P0.05), UA、Alb、Hb、ALT、AST經(jīng)過治療后兩組比較均無統(tǒng)計(jì)學(xué)差異。結(jié)論：益氣養(yǎng)陰清利祛風(fēng)化瘀法對(duì)DNIV期屬氣陰兩虛濕瘀證的患者具有較好的療效,在改善臨床癥狀和降低尿蛋白、控制血糖、穩(wěn)定腎功能方而有較好的效果,值得進(jìn)一步深入研究。
[Abstract]:Objective: to observe and verify the method of nourishing qi, nourishing yin, clearing away wind and removing wind and removing blood stasis, which was summed up by teacher in clinical practice in treating diabetic nephropathy with diabetic nephropathy. Methods: to review relevant literature, collect and excavate the etiology and pathogenesis of traditional Chinese and western medicine about DN, and sort out the main treatment principles and clinical results. Summary and analysis of Qi-nourishing Yin Qingli dispelling wind and removing blood stasis treatment of DNIV patients with syndrome of Qi and Yin deficiency of dampness and stasis between the characteristics between the prescription. The clinical observation cases were divided into two groups randomly: treatment group and control group, and the control group was given routine western medicine treatment. The clinical observation cases were selected from the outpatient and inpatient department of Department of Nephrology, Jiangsu traditional Chinese Medicine Hospital, and were randomly divided into treatment group and control group. On this basis, the treatment group was treated with Qi nourishing Yin, clearing away wind and removing wind and removing blood stasis prescription: ShengHuangqi 30g, Huai yam 10g, Cornel 15g, Rehmannia 12g, Beijing Xuanshen 10g, Trichosanthus 20g. Corn must 15 g, fine stone Wei 30 g, green wind rattan 30 g, late silkworm sand 20 g, ghost arrow 20 g, purple salvia miltiorrhiza 15 g. The course of treatment was 12 weeks. Before and after treatment, the changes of TCM symptom scores were observed. Results: the total effective rate of treatment group was 83.3, the total effective rate of TCM syndrome improvement was 86.7; The total effective rate of the control group was 70 and the total effective rate of improving TCM syndrome was 73.4. In the treatment group, UA was significantly improved after treatment, but not in the control group. There were no significant changes in the two groups after treatment. Comparison between the two groups: in the improvement of U-TPG FPG Scr-bun prescription. The treatment group was superior to the control group (P 0.05). There was no statistical difference between the two groups after AST treatment. Conclusion: the method of supplementing qi, nourishing yin, clearing away wind and removing wind and removing blood stasis has better curative effect on patients with Qi and Yin deficiency and dampness stasis syndrome in DNIV stage. It has good effect in improving clinical symptoms, lowering urine protein, controlling blood sugar and stabilizing renal function.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R259;R277.5

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