益肾泄浊汤治疗2型糖尿病合并慢性肾功能不全I临床研究

目的：探讨益肾泄浊汤加减治疗2型糖尿病合并慢性肾功能不全患者的临床有效性和安全性。方法：将38例2型糖尿病合并慢性肾功能不全患者随机分为治疗组与对照组，每组各19例，对照组患者给予常规治疗盐酸二甲双胍口服，每日1次，1次1片（0．5g）；保肾康口服，每日3次，每次3粒；开同每日3次，1次4～8片。治疗组患者在此基础上加用益肾泄浊汤加减，治疗周期均4周为1个疗程，观察两组治疗前后症状改善以及各监测指标的变化。结果：治疗组治疗后糖尿病检测指标（空腹血糖、餐后血糖、糖化血红蛋白、尿糖）较治疗前均降低（P〈0．05）；肾功能检测指标尿素氮（BUN）较治疗前下降（P〈0．05）；血肌酐（Scr）、肾小球滤过率（GFR）各参数指标均明显改善（P〈0．05），且Scr、Ccr、BUN改善优于对照组治疗后（P〈0．05）；治疗组治疗后症状分级评分、Spitzer评分、cAREs—SF评分分别为（9．92±4．28）分、（7．93±0．14）分、（69．91±12．46）分，生活质量较对照组明显提高（P〈0．05）；治疗组总有效率为89．47％，对照组总有效率为68．42％，病情转归明显优于对照组（P〈0．05）。结论：益肾泄浊汤加减治疗2型糖尿病合并慢性肾功能不全患者能改善患者肾功能，明显提高患者生活质量，可以在临床推广。

Yishen Xiezhuo Decoction in Treating Type 2 Diabetes with chronic Renal Insufficiency Patients

Objective ： To investigate clinical efficacy and safety of Yishen Xiezhuo Decoction in treating type 2 diabetes mellitus with chronic renal insufficiency patients. Methods ：38 type 2 diabetes mellitus patients with chronic renal insuffi- ciency were randomly divided into treatment group and control group, 19 cases in each group. Patients in control group were treated with routine treatment of metformin hydrochloride orally, once a day, one tablet （0.5g） ;Baoshenkang oral- ly, 3 times a day, 3 capsules for each time ; Ketosteri 3 times a day and 4 - 8 tablets for each time. Patients in the treat- ment group on the basis of this combined with Yishen Xiezhuo decoction, 4 weeks was 1 course, observing two groups Symptoms improvement before and after treatment as well as the monitoring index. Results：The diabetes detection indexex （fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin, urine） in treatment group after treatment compared with those before treatment were decreased （P 〈 0.05） ; renal function in blood urea nitrogen （BUN） was de- creased than that before treatment （P 〈 0.05 ） ; serum creatinine （Scr）, glomerular filtration rate （GFR） parameters were significantly improved （ P 〈 0.05 ） , and Scr, Ccr and BUN were better than those in the control group after treat- ment （ P 〈 0.05 ） ; the symptom score, Spitzer score, CARES score of SF in the treatment group after treatment were （ 9.92 ± 4.28 ） %, （ 7.93 ± 0.14 ） %, （ 69.91 ± 12.46 ）, quality of life was improved significantly （ P 〈 0.05 ） ; the to- tal effective rate of treatment group was 89.47%, the total effective rate in control group was 68.42%, the prognosis is better than that of control group （ P 〈 0. 05 ）. Conclusion ： Yishen Xiezhuo Decoction in treating type 2 diabetic patients with chronic renal insufficiency can improve renal function in patients, significantly improve quality of life, can popularize in the clinic.