【作者】 王冠骁；

【导师】 朴春丽；

【作者基本信息】 长春中医药大学 ， 中医内科学， 2012， 硕士

【摘要】 目的：通过观察麦地参肾消汤对消渴肾病（气阴两虚、瘀浊内阻证）患者的临床疗效，以明确评价其临床作用的有效性。方法：收集符合条件的消渴肾病患者（气阴两虚、瘀浊内阻证）60例，病例主要来源于内分泌门诊及疗区，并将入组的患者随机分为治疗组及对照组各30例，治疗组与对照组患者均常规给予内科的基础治疗，对照组患者均给予马来酸依那普利片（商品名依苏）及胰激肽原酶肠溶片（商品名怡开片），治疗组患者在对照组的基础治疗上再加用麦地参肾消汤，本实验治疗的全疗程总计为60天，主要观察比较治疗组与对照组患者治疗前后在症状及体征的缓解情况，并分别记录治疗前后的血糖（空腹静脉血糖、餐后2h静脉血糖）、糖化血红蛋白的数值（HbA1c）、24小时尿蛋白定量、血肌酐（Scr）及尿素氮（BUN）的数值。结果：经足疗程（60天）的治疗后，治疗组与对照组的总有效率分别为80.0%和53.3%，经相关的统计学分析可知有显著的统计学意义（P<0.05）。结论：麦地参肾消汤能够降低尿蛋白的排出，能够有效的使DN患者的血肌酐（Scr）及尿素氮（BUN），能够较为显著地缓解其临床症状，但是对于血糖及HbA1c的水平控制不甚明显，能够有效地提高其临床疗效，推测其主要的作用机制可能与调节物质代谢、减轻DN肾脏的高滤过状态、能够有效降低尿蛋白的排泄率有关，进而改善肾脏微循环，延缓DN的进展速度。更多还原

【Abstract】 Objective: to observe the field of wheat and kidney away nearly soup decoctionof disease (Yin deficiency of both qi and blood stasis, turbidity resistance syndrome)of patients with clinical curative effect, in order to make clear the clinical effectassessment of effectiveness.Methods: the data of meet the conditions of the thirst in patients withnephropathy (gas Yin deficiency of both, blood stasis turbidity resistance card)60cases, cases mainly comes from the endocrine outpatient department and treatmentarea, and the group will be the patients were randomly divided into the treatmentgroup and control group in the30cases, the treatment group and control group toconventional therapy in patients with internal medicine, on the basis of the controlgroup to give the Malay acid of enalaprilat (according to Sue) and pancreatic shockpeptide enzyme enteric-coated metformin hydrochloride (a satisfying open piece), thetreatment group and control group in the basis of wheat field and kidney away withsoup, treatment of the total period of treatment for60days. Observation is thetreatment group and control group patients before and after treatment in symptomsand signs of relief, and before and after treatment were records of an empty stomachvein blood sugar (FPG), after eating2h vein blood sugar (2hPG), glycatedhemoglobin (HbA1c), the numerical24-hour urine protein quantitative numerical,creatinine (Scr) and urea nitrogen (BUN).Results: after treatment for60days, the treatment group and control group totaleffective rate of80.0%and53.3%respectively, and the related significant that thestatistical analysis of the statistical significance (P <0.05).Conclusion: the field of wheat and kidney away soup can reduce the excretion ofurinary protein, be able to effectively make DN patients (Scr) serum creatinine andurea nitrogen (BUN), can obviously alleviate clinical symptoms, but to blood sugarand HbA1c level control what not apparent, can improve the clinical curative effect,the pathogenesis mechanism may and regulation substances metabolism, reduce DN kidney filtration, high state can effectively reduce the urine protein excretion raterelevant, but also improve the microcirculation kidney, delay the progress of the DNspeed.更多还原