降糖保肾方联合厄贝沙坦治疗早期糖尿病肾病的临床研究

目的：探讨降糖保肾方联合厄贝沙坦治疗早期糖尿病肾病的临床疗效,为治疗早期糖尿病肾病寻找最佳途径。方法：将符合纳入标准的108例患者,经洗脱期后,随机分为西药组（X组）,中药组（Z组）,中西医结合组（L组）。分别予厄贝沙坦150mg/次,1次/日,口服;降糖保肾方（免煎剂）：每日2剂,口服;降糖保肾方（免煎剂）每日2剂联合厄贝沙坦150mg每日1次,口服;维持治疗12周,观察治疗前后症状、血糖、蛋白尿、肾功能、血脂、降糖药用量变化。结果：各组治疗前后ALT,Alb,Scr,BUN差异无统计学意义;降糖保肾方显著改善症状积分,显著降低TC,TG,HbA1c,减少胰岛素用量,显著降低餐后2h血糖,显著降低24h尿蛋白,显著降低24h尿微量白蛋白排泄率（P〈0.05）;联合厄贝沙坦后以上作用较单用降糖保肾方更显著（P〈0.05）。结论：降糖保肾方联合厄贝沙坦治疗早期糖尿病肾病疗效显著,值得临床推广使用。

Clinical Study of Jiangtangbaoshenfang Combined with Irbersartan on Treating Early Diabetic Nephropathy

Objective：To investigate the clinical efficacy of Jiangtangbaoshenfang combined with Irbersartan on treating early diabetic nephropathy,it aims to find an optimum way to treat early diabetic nephropathy effectively.Methods：The 108 patients who were in the post-elution period and met the inclusion criteria were randomly divided into the western medicine group（X group）,the traditional Chinese medicine group（Z group）and the combining traditional and western medicine group（L group）;the patients from X group were given oral irbersartan 150mg per time,once per day;the patients from Z group were given oral Jiangtangbaoshenfang two doses per day;the patients from L group were given oral Jiangtangbaoshenfang two doses per day combined with Irbersartan 150mg per time,once per day,The total treatment time was for 12 weeks.The alteration of symptom,blood glucose,proteinuria,renal function,blood lipids and insulin dosages was observed before and after the treatment.Results：The ALT,ALB,Scr and BUN did not have significant difference among three groups.However,Jiangtangbaoshenfang significantly increased symptom score and significantly decreased TC,TG,HbA1c,insulin dosage,2-hour postprandial blood glucose,24-hour urine protein and 24-hour urinary albumin excretion rate（P0.05）.The combined application of Jiangtangbaoshenfang with Irbersartan had better clinical effect than that of Irbersan and Jiangtangbaoshenfang used respectively（P0.05）.Conclusion：Conclusion：The combination of Jiangtangbaoshenfang with Irbersartan had significant effect on treating early diabetic nephropathy and was worth clinical use.