| 摘要: |
| 目的：探讨真武汤合附子理中丸加减方对糖尿病肾病(DKD)脾肾阳虚证的临床疗效。方法：将120 例DKD脾肾阳虚证患者随机分为2组，每组各60例。对照组采用西医常规治疗，治疗组在对照组基础上加用真武汤合附子理中丸加减方治疗。比较2组治疗前后血糖水平［包括空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbA1c）］、肾功能指标［包括血肌酐（Scr）、血尿素氮(BUN)、24h尿蛋白定量、胱抑素 C（Cys-C）］及中医证候积分，评定2组综合疗效及中医证候疗效，观察不良反应情况。结果：综合疗效和中医证候疗效总有效率治疗组分别为83.33%（50/60）、91.67%（55/60），对照组分别为75.00%（45/60）、78.33%（47/60），2组比较，差异均有统计学意义（P＜0.05或P<0.01）。2组治疗后血糖及肾功能指标水平均较治疗前下降，中医证候积分较治疗前降低，且改善程度治疗组均优于对照组，差异均有统计学意义（P<0.05或P<0.01）。治疗组有1例患者出现轻微胃肠道反应，后自行缓解。2组治疗前后血压、心率、肝肾功能及血、尿常规等安全性指标比较，差异均无统计学意义（P>0.05）。结论：真武汤合附子理中丸加减方可有效缓解DKD脾肾阳虚证患者的临床症状，降低血糖水平及尿蛋白含量，保护肾脏功能，安全有效，值得临床推广应用。 |
| 关键词: 糖尿病肾病 脾肾阳虚证 真武汤 附子理中丸 |
| DOI： |
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| Clinical effect of Zhenwu decoction combined with modified Fuzi Lizhong pills in treatment of diabetic kidney disease：An analysis of 60 cases |
| LIU Aijiao |
| (Youxian People’s Hospital，Youxian 412300，Hunan，China) |
| Abstract: |
| Objective：To investigate the clinical effect of Zhenwu decoction combined with modified Fuzi Lizhong pills in the treatment of diabetic kidney disease (DKD) with the syndrome of spleen-kidney Yang deficiency.Methods：A total of 120 DKD patients with the syndrome of spleen-kidney Yang deficiency were randomly divided into treatment group and control group，with 60 patients in each group.The patients in the control group were given conventional Western medicine treatment，and those in the treatment group were given Zhenwu decoction combined with modified Fuzi Lizhong pills in addition to the treatment in the control group.The two groups were compared in terms of blood glucose ［fasting blood glucose (FPG)，2-hour postprandial glucose (2hPG)，and glycosylated hemoglobin (HbA1c)］，renal function parameters ［serum creatinine (Scr)，blood urea nitrogen (BUN)，24-h urinary protein quantification，and cystatin C (Cys-C)］，and TCM syndrome score.Overall response and the treatment outcome of TCM syndrome were evaluated，and adverse reactions were observed.Results：There were significant differences between the treatment group and the control group in overall response ［83.33%(50/60)vs 75.00%(45/60)，P＜0.05］ and the overall response rate of TCM syndrome ［91.67%(55/60)vs 78.33%(47/60)，P＜0.05］.Both groups had significant reductions in blood glucose，renal function parameters，and TCM syndrome score after treatment，and the treatment group had significantly better improvements than the control group (P＜0.05 or P＜0.01).One patient in the treatment group experienced mild gastrointestinal reaction，which was relieved spontaneously.There were no significant differences between the two groups in safety indices such as blood pressure，heart rate，hepatic and renal function，and routine blood/urine test results before and after treatment (P>0.05).Conclusion：In DKD patients with the syndrome of spleen-kidney Yang deficiency，Zhenwu decoction combined with modified Fuzi Lizhong pills has good safety and efficacy and can effectively alleviate clinical symptoms，reduce blood glucose and urinary protein，and protect renal function，and therefore，it holds promise for clinical application. |
| Key words: diabetic kidney disease syndrome of spleen-kidney Yang deficiency Zhenwu decoction Fuzi Lizhong pills |
