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1、提要目的：观察以玉屏风散加味方治疗早期糖尿病肾病的临床疗效。方法：本课题于山东中医药大学附属医院内分泌科住院及门诊随机选取确诊为2型糖尿病肾病Ⅲ期的患者,按就诊顺序随机分为治疗组与对照组。两组患者均给予2型糖尿病基础治疗，控制血糖、血压、血脂。治疗组给予以玉屏风散加味方为基本方辨证治疗，治疗期两组均为1个月。观察两组病人治疗前后的中医证候变化及患者的血糖、糖化血红蛋白、血脂、血压及尿微量白蛋白排泄率等指标水平变化。结果：经临床观察，治疗组在改善患者临床症状和相关检验指标方面较对照组有显著优势，在改善患者尿微量白蛋白排泄率方面要显著优于对照组（P<0.05）。且患者血常规、尿常规
2、、大便常规、肝功、肾功及心电图治疗前后无异常改变，亦未出现不良反应，具有良好的安全性。结论：玉屏风散加味方用于早期糖尿病肾病的治疗，能显著减少患者尿微量白蛋白的排泄，阻止大量蛋白尿的出现，延缓甚至阻断病情进展，且能显著改善患者临床症状，同时联合西药常规治疗，其疗效优于单纯西药治疗。关键词糖尿病肾病；临床研究；辨证论治；补肾健脾；玉屏风散ClinicalResearchofYupingFengSanintreatingearlydiabeticnephropathySpeciality:InternalmedicineoftraditionalChineseMedicineAut
3、hor:RenLeiTutor:Prof.YangWenjunAbstractObjective:ToobservetheYupingfengSanonthetreatmentofearlydiabeticnephropathy.Methods:ThistopicintheAffiliatedHospitalofShandongUniversityofTraditionalChineseMedicineDepartmentofEndocrinologyinpatientandoutpatientwererandomlyselectedwithtype2diabeticnephr
4、opathypatientsinphaseⅢ.Allpatientswererandomlydividedintotreatmentgroupandcontrolgroup.Twogroupsofpatientsweregivenintype2diabeticbasictherapy,controlglycaemic,bloodpressure,andbloodlipid.ThetreatmentgroupweregiveninYupingfengSanasbasicmethodoftreatmentbasedonsyndromedifferentiation,treattwo
5、groupsfor1months.ToobservetwogroupsofpatientsbeforeandaftertreatmentofChinesemedicinesyndromesandchangesofbloodglucose,HbA1c,lipids,bloodpressureandurinaryalbuminexcretionrateandotherindicatorsofchangesinthelevel.Results:Throughclinicalobservation,thetreatmentgroupinimprovingsymptomsandrelat
6、edindexesweresignificantlyadvantage,intheimprovementofpatientswithurinaryalbuminexcretionratetobesignificantlybetterthanthecontrolgroup(P<0.05).Intheroutineanalysisofblood,urine,andstoolroutine,liverandkidneyfunctionandelectrocardiogrambeforeandaftertreatmentwithnoabnormalchange,atthesametim
7、ewithoutadversereaction,withgoodsecurity.Conclusion:YupingfengSanmodifiedrecipefortreatmentofdiabeticnephropathyinearlystage,cansignificantlyreducethepatientswithurinaryalbuminexcretion,preventmassiveproteinuria,delayingorevenblockingtheprogressoft
