中图分类号：R255.4 文献标识码：A 文章编号：1674-7860（2016）09-0056-02 证型：DBG
【摘 要】目的：探讨桂附地黄汤加减治疗2型糖尿病肾病V期阴阳两虚、水瘀互结、浊毒内停证的治疗效果。方法：选择2011年7月—2015年6月我院住院治疗的2型糖尿病肾病V期阴阳两虚、水瘀互结、浊毒内停证病人240例，采用降糖、降压、降脂及胰激肽原酶等治疗120例作为对照组，在西医治疗基础上加服桂附地黄汤加减120例作为治疗组。两组持续治疗3个月。观察并比较两组治疗前后主要症候改善、空腹血糖、糖化血红蛋白、血脂、24 h尿蛋白定量（UAE）肾功能及内生肌酐清除率（Ccr）测定生化指标变化。结果：对照组总有效率为63.3%，治疗组总有效率77.5%，P＜0.05，差异有统计学意义，两组治疗后各项生化指标均明显改善，差异具有统计学意义，治疗组血清甘油三酯、UAE、血清尿素、血清肌酐和Ccr改善优于对照组，P＜0.05，差异有统计学意义。结论：西药配合桂附地黄汤加减治疗2型糖尿病肾病V期阴阳两虚、水瘀互结、浊毒内停证效果显著，能有效延缓2型糖尿病肾病Ⅴ期进展，改善病人生活质量。
【Abstract】Objective: To explorethe therapeutic effect ofModified Guifu Dihuang Decoction in treating Yinand Yangdeficiency, mutual stasis of water and bloodsyndrome of patients with type 2 diabetic nephropathy V phase. Methods:240patients withtype 2 diabetic nephropathy V phase and manifested in Yin and Yang deficiency,mutual stasis of water and blood, damp turbidity syndrome, who were admittedand treated in our hospital from July 2011 to June 2015, were divided into thecontrol group (120 cases), who received hypoglycemic, antihypertensive, lipidlowering and pancreatic treatment and the treatment group (120 cases), who received Modified Guifu DihuangDecoction on the basis of the treatment of the control group. The treatmentlasted 3 months. The main symptoms improvement, the changes of determination ofbiochemical parameters of fasting blood glucose, glycosylated hemoglobin, bloodlipids, 24 hours urinary protein quantitation (UAE) renal function andendogenous creatinine clearance rate (Ccr) of patients in two groups before andafter the treatment were observed and compared. Results:The total effective rate of thecontrol group was 63.3% while that of the treatment groupwas 77.5%, x2=6.26 and P<0.05by x2test，thedifference was of statistical significance; after treatment, the biochemicalindexes of two groups all improved significantly, t test was applied and the difference was of statisticalsignificance; the improvement of the serum triglyceride, UAE, serum urea, serumcreatinine and Ccr of the treatment group was significantly better than of thecontrol group, tvalue of these five indexes was above 1.965，P<0.05 by t test，the difference was of statistical significance. Conclusion: Thecombination of Modified Guifu Dihuang Decoction and western medicine hadsignificant effect in treating patients with type 2 diabetic nephropathy Vphase and manifested in Yin and Yangdeficiency, mutual stasis of water and blood,damp turbidity syndrome, it could delay the progression oftype 2 diabetic nephropathy stage effectively and improve the life quality ofpatients.
【Keywords】Type 2 diabetic nephropathy V phase;Yinand Yangdeficiency; Mutual stasis of water and bloodsyndrome; ModifiedGuifu Dihuang Decoction