中药拔罐联合真武汤治疗脾肾阳虚型糖尿病肾病的临床研究

黄科 董银燕 石程秀

[摘要] 目的 探討中药拔罐联合真武汤治疗脾肾阳虚型糖尿病肾病的疗效。 方法 选择2018年1月～12月于本院就诊的脾肾阳虚型糖尿病肾病患者60例，随机分为治疗组30例和对照组30例，两组患者均采用基础治疗并口服中药真武汤加减方，治疗组加用中药拔罐治疗，1个月后评价两组疗效，并观察血尿素氮（BUN）、血肌酐（Scr）、尿α1微球蛋白（A1M）、尿N-乙酰-β-D-葡萄糖苷酶（NAG）等指标的改善情况。 结果 治疗组改善临床证候的总有效率为93.33%，明显优于对照组（P<0.05）;治疗组的血BUN、血Scr、尿A1M、尿NAG指标改善，治疗前后比较有显著差异（P<0.05），与对照组治疗后指标比较，亦有显著差异（P<0.05）。 结论 在脾肾阳虚型糖尿病肾病的治疗中，药物拔罐联合真武汤治疗可取得更为理想的效果，能有效改善患者生活质量，延缓肾功能恶化，值得推广。

[关键词] 中药拔罐;真武汤;脾肾阳虚;糖尿病肾病

[中图分类号] R255.4          [文献标识码] B          [文章编号] 1673-9701（2020）16-0136-04

Clinical study of traditional Chinese medicine cupping and Zhenwu decoction in treating diabetic nephropathy of spleen and kidney Yang-deficiency

HUANG Ke   DONG Yinyan    SHI Chengxiu

Department of Nephrology， Jiaxing Traditional Chinese Medicine Hospital， Jiaxing   314000， China

[Abstract] Objective To analyze the effect of traditional Chinese medicine cupping and Zhenwu decoction in treating diabetic nephropathy of spleen and kidney Yang-deficiency. Methods A total of 60 patients with diabetic nephropathy of spleen and kidney yang-deficiency treated in our hospital from January to December 2018 were randomly divided into a treatment group（n=30） and a control group（n=30）. Both groups received basic treatment and oral Chinese medicine modified Zhenwu decoction， and the treatment group was treated with traditional Chinese medicine cupping on this basis. After 1 month， the curative effect of the two groups was evaluated， and indicators such as blood urea nitrogen（BUN）， serum creatinine（Scr）， urine α1 microglobulin（A1M）， and N-acetyl-beta-D-glucusamidase（NAG） were monitored. Results The total effective rate of clinical syndromes in the treatment group was 93.33%， which was significantly better than that in the control group（P<0.05）. There were statistical differences in BUN， Scr， urine A1M， and urine NAG before and after treatment in the treatment group; and there were statistical differences in BUN， Scr， urine A1M， and urine NAG between the treatment group and the control group（P<0.05）. Conclusion In the treatment of spleen and kidney yang-deficiency diabetic nephropathy， traditional Chinese medicine cupping combined with Zhenwu decoction can achieve more ideal results， effectively improve the quality of life of patients， delay the deterioration of renal function， and is worth promoting.

[Key words] Chinese medicine cupping; Zhenwu decoction; Spleen and kidney Yang-deficiency; Diabetic kidney disease

随着生活水平提高，糖尿病的患者数量呈明显上升趋势，而糖尿病并发症也随之高发，其中糖尿病肾病（Diabetic kidney disease，DKD）是糖尿病最难控制的并发症之一。研究发现，我国糖尿病患者约有10～40%会发展至DKD，与不合并DKD的糖尿病患者相比，DKD患者死亡率更高[1]。DKD发病机制复杂，目前尚未阐明，遗传和环境因素在疾病进展中起着关键作用[2]，而DKD一旦出现显性蛋白尿，将呈不可逆进展，最终发展至终末期肾病。近年来，中医理论一般将该病归于“消渴”、“水肿”等范畴，其辨治多從脾肾论治，且阳虚者居多。本院开展药物拔罐联合真武汤治疗脾肾阳虚型DKD，在改善患者临床症状，延缓肾脏病进展方面疗效显著，现报道如下。

1 对象与方法

1.1 研究对象

选择2018年1月～12月在嘉兴市中医医院住院治疗的60例脾肾阳虚型DKD患者，随机分为对照组和治疗组，每组各30例。对照组中男17例，女13例，年龄……