翟涛

[摘要]目的 探讨中西医结合治疗糖尿病肾病IV期的疗效及对各实验指标的影响。方法 回顾性分析2015年6月～2016年6月我院68例糖尿病肾病IV期患者病例资料，并根据治疗方法分成治疗组（36例）和对照组（32例），对照组患者采用西医常规及对症治疗，治疗组在对照组治疗基础上加用中医治疗，并于3个月后比较其临床疗效。结果 治疗后治疗组总有效率显著高于对照组（P<0.05），治疗组患者治疗后倦怠乏力、腰膝酸软、畏寒肢冷、夜尿清长临床症状积分改善显著优于对照组（P<0.05），各血脂指标以及BUN、Scr、UA、Hb、Alb等肾功能指标改善显著优于对照组（P<0.05）。且均未见明显不良反应。 结论 中西医结合治疗糖尿病肾病IV期能提高患者治疗效果，明显改善患者肾脏功能，改善患者临床症状及其肾功能、血脂等临床实验指标，安全有效值得推广。

[关键词]糖尿病肾病；IV期；中西医结合；肾功能；临床症状积分

[中图分类号] R587.2 [文献标识码] A [文章编号] 2095-0616（2017）11-77-03

Curative effect of combining traditional Chinese and western medicine treatment of diabetic nephropathy IV stage analysis

ZHAI Tao

The Traditional Chinese and Western Medicine Hospital of Zibo City， Zibo 255026， China

[Abstract] Objective To explore the effect of Chinese and western medicine on the treatment of diabetic nephropathy IV and its effects on the experimental indexes. Methods Retrospectively 68 cases of diabetic nephropathyIV stage in our hospital from June 2015 to June 2016 were adopted and divided into treatment group（36 cases） and control group（32 cases）. Patients in control group were treated by conventional western medicine and symptomatic treatment， On the basis of control group， the patients in treatment group were treated with Chinese medicine. Before and after treatment，the clinical efficacy were compared between two groups. Results After treatment， the rate of total efficiency in treatment group were significantly higher than those in control group（P<0.05）. The clinical symptom score（Fatigue， weak waist knee， cold limb cold， night urine long） of treatment group were better than those of the control group （P<0.05）. The level of blood fat and renal function（BUN、Scr、UA、Hb、Alb）in the treatment group were significantly improved than those in the control group（P<0.05）. No obvious adverse reactions were observed in two groups. Conclusion Combine traditional Chinese and western medicine treatment of diabetic nephropathy patients with stage IV can improve the treatment effect， significantly improve patients with renal function， improve patients' clinical symptoms and renal function， blood lipids and other clinical trials， safe and effective is worth promoting.

[Key words] Diabetic nephropathy； IV stage； Combine traditional Chinese and western medicine； Renal function； Inflammatory cytokines； Clinical symptom score

糖尿病腎病（diabetic nephropathy，DN）是最常见的糖尿病慢性并发症，属于严重的慢性微血管并发症之一[1]。有研究2型糖尿病（DM）患者中患DN者占到34.7%，而因DN导致患者死亡约占DM患者的30%[2]。DN起病缓慢，多数患者一经确诊，都已达DN Ⅲ期或Ⅳ期，甚至终末期[3]。中西医结合方法治疗本病目前有着很大优势。我院采用中西医结合治疗DN IV期患者效果满意，现报道如下。

1 资料与方法

1.1 一般资料

全部病例为2015年6月～2016年6月我院68例糖尿病肾病IV期患者资料，所有患者均确诊为Mogensen分期的IV期糖尿病肾病[4]，纳入标准：病例完整；空腹血糖≤7.8mmol/L，餐后2h血糖≤ 11.1mmol/L；持续尿蛋白>0.5g/24h，<3.0g/24h。排除标准：排除严重感染和糖尿病急性并发症患者；排除精神病和其它严重脏器疾病者等；排除患有肾血管疾病、慢性肾炎患者；排除恶性肿瘤患者。根据其治疗方法分为治疗组36例和对照组32例，两组患者其一般资料比较无显著性差异，具有可比性（P>0.05）。

1.2 治疗方法

所有患者入院后均予运动锻炼及饮食控制，同时对症控制血糖、血压，降低血脂，减轻水肿，预防感染，纠正贫血，纠正水电解质紊乱等。……