真武汤合桂枝茯苓丸治疗水瘀互结型糖尿病肾病的临床研究

廖红霞 颜日阳 肖新李

摘要：目的 對真武汤合桂枝茯苓丸治疗水瘀互结型糖尿病肾病的临床效果进行研究。方法 选取 2016 年 10 月 - 2018 年 3 月期间 120 例在本院接受中医诊断后，确诊为水瘀互结型糖尿病肾病患者，并将患者分为对照组与观察组，每组各60例，对照组给予西医规范化治疗，观察组在对照组基础上给予真武汤合桂枝茯苓丸，2组均治疗2个疗程，14d/疗程，共28d，比较2组的实验室指标、中医证候学评分和临床疗效。结果 经过两个疗程的治疗后，2组与治疗前相比较均有显著性差异（P<0.01），但观察组中畏寒、腰肢酸痛、便溏、面浮肢肿的改善程度均明显优于对照组（P<0.01），观察组中乏力症状与对照组比较有显著性差异（P<0.05）。观察组患者治疗后的空腹血糖、餐后2h的血糖较对照组有显著性差异（P<0.05）;观察组的24h微量白蛋白、血尿素氮、血肌酐指标较对照组是有明显差异的（P<0.01），并且2组患者治疗期间均未有明显不良反应。结论 真武汤合桂枝茯苓丸可有效改善水瘀互结型糖尿病肾病，有效提高患者身体耐受性，改善水肿、畏寒、腰肢酸痛等症状，能够有效的保护患者的肾脏，延缓疾病的进展，增加患者的获益时间，是临床中值得推广的用药方案。

关键词：真武汤;桂枝茯苓丸;水瘀互结型;糖尿病肾病

中图分类号：R587.2 文献标志码：B 文章编号：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.