肾衰合剂联合清热解毒灌肠液治疗糖尿病肾病Ⅳ期临床研究

【作者】 周良发；

【导师】 薛莎；

【作者基本信息】 湖北中医学院 ， 中医内科学， 2007， 硕士

【摘要】 目的：研究肾衰合剂联合清热解毒灌肠液对糖尿病肾病Ⅳ期患者的疗效，并探讨其可能机制。方法：将确诊为脾肾气阴两虚的糖尿病肾病Ⅳ期，血肌酐(Scr)在400～530umol／L的66例患者，随机分为2组：肾衰合剂联合清热解毒灌肠液组(简称治疗组)，爱西特组(简称对照组)，每组各33例，均在一般治疗基础上，治疗组加用肾衰合剂口服和清热解毒灌肠液灌肠治疗，对照组加用爱西特治疗；疗程均为8周。治疗前后检测糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、24h尿蛋白定量(24hu-TP，pro)、血尿素氮(BUN)、血肌酐(Scr)、内生肌酐清除率(Ccr)等指标，并记录临床症状变化，进行分析比较。结果：(1)在有效率方面，治疗组总有效率84.8％，对照组总有效率60.6％，经检验，P＜0.05，两组有效率比较有统计学意义。(2)在临床症状积分方面，治疗组与对照组经治疗后症状积分均下降，经检验，与治疗前比较有统计学意义(P＜0.05)，两组治疗后比较亦有统计学意义(P＜0.05)。(3)治疗组前后HbA1c、TG、TC、LDL均明显下降，分别与治疗前比较有统计学意义(P＜0.05)，对照组上述各指标亦有改善，但与治疗前比较无统计学意义(P＞0.05)。两组治疗后比较有统计学意义(P＜0.05)。(4)治疗组前后pro、BUN、Scr、Ccr均明显改善，与治疗前比较有统计学意义(P＜0.05)；对照组治疗前后除pro(P＞0.05)外，BUN、Scr、Ccr均明显改善(P＜0.05)，组间比较有统计学意义(P＜0.05)。结论：肾衰合剂联合清热解毒灌肠液具有明显降低血肌酐，减少蛋白尿，促进脂代谢，增加体内毒素排出，保护患者残存肾功能，改善临床症状，延缓肾衰竭进程，提高了患者的生存质量。更多还原

【Abstract】 Objective:To study treatment effect of Shenshuai Mixture integrated heat-cleating,detoxication and enema liquid treating patients with diabetic nephropathy inⅣphaseand explore the probable mechanism.Methods:The 66 patients diagnosed the type of both Qi-Yin deficiency of Kidney-Spleenin diabetic nephropathy inⅣphase and their Scr in range of 400～530umol/L wereequally divided into the treatment group and the control group (treated by MedicinalCharcoal Tablets). All patients were treated by basic methods. In addition, the patientsin treatment group were treated by shenshuai Mixture integratedheat-clearing ,detoxication and enema liquid, while the patients in control group tookMedicinal Charcoal Tablets. The period of treatment was 8 weeks. The indexesincluding HbA1c、TG、TC、LDL、24 hours urinary protein quantity(24hu-TP,pro),Scr、Ccr and so on were measured before and after treatment. The clinic symptomswere recorded and analyzed.Results:(1) In term of efficiency, the treatment was 84.8% and the control was 60.6%.By tested, the difference in two groups was obvious, so P＜0.05.(2) In term of clinic symptoms integral, the integrals in two groups wereimproved after treatment. By tested, the difference had statistical significance incontrast of before treatment (P＜0.05). After treatment the difference in two groupswas obvious (P＜0.05).(3) After treatment, the treatment group could decrease HbA1c、TG、TC、LDLmarkedly ,the differences were obvious (P＜0.05). The control group also couldimprove HbA1c、TG、TC、LDL.But there were no significant difference(P＞0.05). Bytested, The difference in two groups was also obvious after treatment (P＜0.05).(4) shenshuai Mixture integrated heat-clearing, detoxication and enema liquidcould improve Pro、BUN、Scr and Ccr .The differences were obvious (P＜0.05). Thecontrol group also could improve BUN、Scr and Ccr distinctly, except Pro. The differences were also obvious (P＜0.05). By tested, The difference in two groups wasalso obvious after treatment (P＜0.05).Conclusion:It can obviously drop serum creatinine, decrease urinary protein quantity、accelerate fat metabolism、increase toxin expelling from bodies、protect residual renalfunction、improve clinical symptoms and delay the progress of renal failure bytreatment of Shenshuai Mixture integrated heat-cleating, detoxication and enemaliquid, so it can improve the quality of life of patients.更多还原