温补脾肾 化瘀利水法治疗脾肾阳虚夹湿瘀型糖尿病肾病水肿临床分析

目的探讨温补脾肾、化瘀利水法治疗脾肾阳虚夹湿瘀型糖尿病肾病水肿的疗效和机制。方法本研究采用随机对照研究,选择长春中医药大学附属医院门诊和住院脾肾阳虚夹湿瘀型糖尿病肾病水肿患者进行随机分组。对照组给予降糖、降压、降脂等对症治疗;治疗组在对照组治疗基础上,给予温补脾肾、化瘀利水法治疗,口服中药汤剂,以金匮肾气丸、大黄虫丸为基础方加减。结果数据经统计分析显示,治疗后治疗组24 h UTP、Cr、BUN明显下降,与治疗前相比,差异有统计学意义(P<0.05),且ALB、尿量均较前明显增加,差异有统计学意义(P<0.05);对照组治疗后24 h UTP、Cr、BUN有所下降,与治疗前相比,差异有统计学意义(P<0.05),但ALB、尿量均较前减少,组间比较,治疗组明显优于对照组(P<0.05)。治疗组的总有效率96.67%(29/30)高于对照组66.67%(20/30),差异有统计学意义(P<0.05)。结论温补脾肾、化瘀利水法能减轻脾肾阳虚夹湿瘀型糖尿病肾病水肿,延缓进入血液透析的时间。

Clinical Analysis on Nourishing Spleen and Kidney,Removing Blood Stasis and Inducing Diuresis Method in the Treatment of Diabetic Nephropathy Edema Caused by Spleen-kidney Yang Deficiency Combined with Dampness Stasis

Objective To explore the therapeutic effect and mechanism of nourishing spleen and kidney,removing blood stasis and inducing diuresis method in the treatment of diabetic nephropathy edema caused by spleen-kidney yang deficiency combined with dampness stasis.Methods A randomized controlled study was conducted in this study to select the outpatient and inpatient patients with nephrotic edema caused by spleen-kidney yang deficiency combined with dampness-blood stasis in our hospital.The control group was given symptomatic treatment such as hypoglycemic,hypotensive,lipid-lowering,etc,and was not given oral traditional Chinese medicine decoction.The treatment group was treated nourishing spleen and kidney,removing blood stasis and inducing diuresis method on the basis of control group,and was given decoction,Jingui Shenqi pill and Dahuang Zhechong pills.Results Statistical analysis of the data showed that 24 hUTP,Cr and BUN in the treatment group decreased significantly after treatment,and the differences were statistically significant(P<0.05),and ALB and urine volume increased significantly compared with before treatment,the differences were statistically significant(P<0.05).In the control group,24 hUTP,Cr and BUN decreased after treatment,and the differences were statistically significant compared with before treatment(P<0.05),but ALB and urine volume decreased,and the treatment group was significantly better than the control group(P<0.05).The total effective rate in treatment group was 96.67%(29/30)higher than 66.67%(20/30)in control group,and the difference was statistically significant(P<0.05).Conclusion The nourishing spleen and kidney,removing blood stasis and inducing diuresis method can reduce the edema of nephropathy caused by spleen-kidney yang deficiency and moistening blood stasis type,and delay the time of entering hemodialysis.