真武湯合桂枝茯苓丸治療水瘀互結型糖尿病腎病的臨床研究

廖紅霞 顏日陽 肖新李

摘要：目的 對真武湯合桂枝茯苓丸治療水瘀互結型糖尿病腎病的臨床效果進行研究。方法 選取 2016 年 10 月 - 2018 年 3 月期間 120 例在本院接受中醫診斷后，確診為水瘀互結型糖尿病腎病患者，并將患者分為對照組與觀察組，每組各60例，對照組給予西醫規范化治療，觀察組在對照組基礎上給予真武湯合桂枝茯苓丸，2組均治療2個療程，14d/療程，共28d，比較2組的實驗室指標、中醫證候學評分和臨床療效。結果 經過兩個療程的治療后，2組與治療前相比較均有顯著性差異（P<0.01），但觀察組中畏寒、腰肢酸痛、便溏、面浮肢腫的改善程度均明顯優于對照組（P<0.01），觀察組中乏力癥狀與對照組比較有顯著性差異（P<0.05）。觀察組患者治療后的空腹血糖、餐后2h的血糖較對照組有顯著性差異（P<0.05）;觀察組的24h微量白蛋白、血尿素氮、血肌酐指標較對照組是有明顯差異的（P<0.01），并且2組患者治療期間均未有明顯不良反應。結論 真武湯合桂枝茯苓丸可有效改善水瘀互結型糖尿病腎病，有效提高患者身體耐受性，改善水腫、畏寒、腰肢酸痛等癥狀，能夠有效的保護患者的腎臟，延緩疾病的進展，增加患者的獲益時間，是臨床中值得推廣的用藥方案。

關鍵詞：真武湯;桂枝茯苓丸;水瘀互結型;糖尿病腎病

中圖分類號：R587.2 文獻標志碼：B 文章編號：1007-2349（2018）09-0047-03

Clinical Study on Zhenwu Decoction Combined with Guizhi Fuling Pill in the Treatment

of Watery Stasis Type Diabetic Nephropathy Patients

LIAO Hong-xia， YAN Ri-yang， XIAO Xin-li

（ Traditional Chinese Medicine Hospital of Heyuan City， Heyuan 517000， China）

【Abstract】Objective： To study the clinical effect of Zhenwu Decoction combines with Guizhi Fuling Pill in the treatment of watery stasis type diabetic patients with nephropathy. Methods： 120 patients who were diagnosed as watery stasis type diabetic patients with nephropathy were treated in the hospital from October 2016 to March 2018. The patients were divided into the control group and the observation group， 60 cases per group. The control group was given standardized treatment of western medicine and the observation group was given Zhenwu Decoction and Guizhi Fuling Pill in the baseline of the control group. Both groups were treated for 2 courses， 14 days a course， for 28 days. In the end， the laboratory indexes， TCM syndromes and rating and clinical efficacy of the two groups were compared. Results： After two courses of treatment， there were significant differences between the two groups before treatment （P<0.01）， but the improvement of chills， lumbar pain， loose stools and facial floating limbs in the observation group were better than those in the control group （P<0.01）. The fatigue symptoms in the observation group were significantly different from those in the control group （P<0.05）. The fasting blood glucose and the blood glucose at 2 h after the treatment in the observation group were significantly different from those in the control group （P<0.05）. The 24 h microalbumin， blood urea nitrogen and serum creatinine indexes in the observation group were significantly different from those in the control group （P<0.01）， and there were no significant adverse reactions during the treatment of the two groups. Conclusion： Zhenwu Decoction combines with Guizhi Fuling Pill can effectively improve the blood stasis type of diabetic nephropathy and the patients body tolerance， and improve the symptoms of edema， chills， waist and limb pain and some other symptoms， which effectively protects the patients kidney and delay the progress of the disease， thus increasing the patients benefit time， worthy of wide application.