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目的:观察益气软坚方结合西药治疗IV期糖尿病肾病的临床疗效。方法:选取64例符合标准糖尿病肾病IV期患者,随机分为治疗组和对照组,两组均用糖尿病基础疗法加口服氯沙坦钾片治疗。治疗组在此基础上根据中医辨证论治,自拟益气软坚方(黄芪、白术、鬼箭羽、茯苓、木香、葛根等)治疗。观察治疗前后效果和尿微量蛋白及肾功能情况。结果:治疗组疗效明显高于对照组(P<0.01),两组治疗前后中医症候积分比较中,两组治疗后各个症状均较治疗前有所改善,其中治疗组的改善程度较对照组明显(P<0.01),治疗前后尿微量蛋白及肾功能比较均有所好转,其中治疗组的尿微量蛋白减少量较对照组多(P<0.01),2组均无明显不良反应出现。结论:采取益气软坚方结合西医常规疗法治疗IV期糖尿肾病,能取得较好效果,改善症状降低尿蛋白。
Objective: To observe the clinical efficacy of Yiqi Ruanjian combined with western medicine in the treatment of stage IV diabetic nephropathy. Methods: Sixty-four patients with stage IV diabetic nephropathy were selected and randomly divided into treatment group and control group. Both groups were treated with losartan potassium tablets with basic diabetes mellitus. On this basis, the treatment group was treated according to the syndrome differentiation of traditional Chinese medicine and self-made qi-qi soft herbs (Astragalus, Atractylodes, ghost feather, Poria, woody, puerarin, etc.). Before and after treatment to observe the effect and urine protein and renal function. Results: The curative effect of the treatment group was significantly higher than that of the control group (P <0.01). Before and after the treatment, the TCM symptom scores of the two groups were better than those before treatment, and the improvement of the treatment group was more obvious than that of the control group (P <0.01). Before and after treatment, the urinary microalbuminuria and renal function were improved. The decrease of urinary microalbuminuria in the treatment group was more than that in the control group (P <0.01). No obvious adverse reactions occurred in the two groups. Conclusion: The treatment of stage IV diabetic nephropathy by combining Yiqijianjian with traditional western medicine can achieve better results and reduce symptoms of proteinuria.