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[目的]观察芪术汤联合西药治疗糖尿病肾病疗效。[方法]使用随机平行对照方法,将86例门诊患者按随机数字表分为两组。对照组43例低分子肝素钙注射液2500u皮下注射,2次/d。血管紧张素II受体拮抗剂类药物和血管紧张素转换酶抑制剂,同时使用降压以钙离子为主的阻滞剂,或者采用口受体阻滞。高血脂患者服用他汀类药物,浮肿患者可酌情给予利尿类药物。治疗组43例芪术汤(当归15g,黄芪40g,苍术20g,大黄、黄柏、水蛭、地龙各10g)。1剂/d,水煎400mL,早晚口服。西药治疗同对照组。两组均连续治疗60d为1疗程。观测临床症状、中医症候积分、血浆肾上腺髓质素、不良反应。连续治疗1疗程,判定疗效。[结果]治疗组完全缓解22例,部分缓解9例,好转8例,无效4例,总有效率90.70%。对照组完全缓解13例,部分缓解7例,好转13例,无效10例,总有效率76.74%。治疗组疗效优于对照组(P<0.05)。两组相关指标均有改善(P<0.05),治疗组改善优于对照组(P<0.05)[结论]芪术汤联合西药治疗糖尿病肾病效果显著,值得推广。
[Objective] To observe the curative effect of Qizhu Decoction combined with Western medicine on diabetic nephropathy. [Methods] Using randomized parallel control method, 86 outpatients were divided into two groups according to random number table. Control group, 43 cases of low molecular weight heparin calcium injection 2500u subcutaneous injection, 2 times / d. Angiotensin II receptor antagonist drugs and angiotensin converting enzyme inhibitors, while using antihypertensive calcium-based blockers, or the use of oral receptor block. Patients with high cholesterol taking statins, edema patients may be given diuretic drugs. Treatment group, 43 cases of Qizhu Decoction (Angelica 15g, Astragalus 40g, herb 20g, rhubarb, Treats, leeches, earthworm each 10g). 1 / d, decoction 400mL, sooner or later oral. Western medicine treatment with the control group. Two groups were treated for 60 days for a course of treatment. Observation of clinical symptoms, TCM symptom scores, plasma adrenomedullin, adverse reactions. Continuous treatment of a course of treatment to determine the efficacy. [Result] In the treatment group, 22 cases were completely relieved, 9 cases partially relieved, 8 cases improved, 4 cases ineffective, and the total effective rate was 90.70%. Control group completely relieved in 13 cases, partial remission in 7 cases, improved in 13 cases, ineffective in 10 cases, the total effective rate was 76.74%. The treatment group was better than the control group (P <0.05). (P <0.05). The treatment group improved better than the control group (P <0.05). [Conclusion] The treatment of diabetic nephropathy with Qizhu Decoction combined with western medicine has remarkable effect and is worth promoting.