中药联合贝那普利治疗糖尿病肾病的临床观察

目的 观察中药联合贝那普利对糖尿病肾病（diabetic nephropathy,DN）患者肾功能的保护作用.方法 采用分层、随机、对照方法,将入选的108例糖尿病肾病患者分为两组.两组给以相同饮食、运动、教育、降糖和对症处理,治疗组采用中药联合贝那普利治疗,对照组单纯用贝那普利治疗,疗程均3个月,观察治疗前后症状体征变化,测定24 h尿蛋白总量（24-hour urinary protein,24 hUpro）、血肌酐（serum creatimine,SCr）,肌酐清除率（serum creatinine clearance rate,CCr）、尿素氮（blood urea nitrogen,BUN）、血糖（plasma glucose,PG）、血压（blood pressure,BP）,记录开始透析治疗时间.结果 治疗后治疗组24 hUpro、SCr降低、CCr升高（P＜0.01）,而且优于对照组（P＜0.05,P＜0.01）;而BUN、PG、BP变化组间比较差异无显著性（P＞0.05）;治疗组肾脏生存时间长于对照组.结论 中药联合贝那普利方案可明显降低SCr和24 hUpro、升高CCr,对肾功能改善优于单纯贝那普利方案.

Clinical Observation on Treatment of Diabetic Nephropathy with Chinese Drugs Combined with Benazepril

Objective To observe the protective effect on renal function of Chinese drugs combined with benazepril in patients with diabetic nephropathy (DN). Methods Adopting stratified randomized and controlled design, 108 patients with DN were assigned to two groups. Besides the same measures of diet regulation, exercise, education, hypoglycemic and symptomatic treatment applied, benazepril was administered to all patients, and Chinese drugs were given to patients in the treated group additionally. The treatment course was 3 months. The changes before and after treatment of symptoms and signs, 24-h urinary protein (24 hUpro), serum creatinine (SCr), serum creatinine clearance rate (CCr), blood urea nitrogen (BUN), plasma glucose (PG) and blood pressure (BP) were observed, and the time of dialysis therapy initiating was recorded. Results SCr and 24 hUpro decreased and CCr increased in the treated group significantly (P<0.01), and the improvement were superior to that in the control group (P<0.05 or P<0.01), the renal living time in the treated group was longer than that in the control group, but no significant different in BUN, PG and BP was found between the two groups (P>0.05). Conclusion The treatment program of Chinese drugs combined with benazepril could obviously reduce the levels of SCr and 24 hUpro, increase CCr in patients with DN, and its effect in improving renal function is better than that of using benazepril alone.