糖肾1号方治疗早期糖尿病肾病44例

目的： 观察糖肾1号方治疗早期糖尿病肾病的临床疗效及对人组织型纤溶酶原激活剂（t-PA）和纤溶酶原激活剂抑制因子（PAI-1）的影响。 方法： 88例患者采用随机按数字法分为观察组和对照组各44例。在控制血压和血糖的基础上，对照组服用卡托普利片，12.5 mg/次，3次/d；观察组在对照组治疗的基础上加用糖肾1号方，1剂/d。两组疗程均为12周。检测治疗前后24 h尿蛋白（UAER），尿微量白蛋白与肌酐的比值（ACR）、空腹血糖（FPG）、和糖化血红蛋白（HbAlc）；检测治疗前后胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）水平；检测治疗前后血清t-PA和PAI-1水平，检测治疗前后血浆D-二聚体（D-D）、血小板聚集率和血浆纤维蛋白原（FIB）。 结果： 观察组总有效率90.91%，对照组为68.18%，观察组优于对照组（P<0.05）；治疗后观察组UAER和ACR水平低于对照组（P<0.01）；治疗后观察组TC，TG，LDL-C水平低于对照组（P<0.01），HDL-C水平高于对照组（P<0.01）；观察组t-PA升高，并高于对照组（P<0.01），观察组PAI-1水平下降，并低于对照组（P<0.01）；治疗后观察组FIB，D-D和血小板聚集率均比治疗前下降，并低于对照组（P<0.01）。 结论： 糖肾1号方能调节t-PA/PAI-1活性，降低D-D，FIB和血小板聚集率，改善脂代谢，降低血液黏度，减少UAER，对早期DN肾功能有一定保护作用。

Tangshen 1 Number Decoction in Treating Early Diabetic Nephropathy with 44 Cases

Objective: Observe clinical effect of Tangshen 1 number decoction and influence to People tissue type plasminogen activat(t-PA) and plasminogen activator inhibitor(PAI-1) in treating early diabetic nephropathy. Method: Eighty-eight patients were randomly divided into control group (44 cases) and observation group (44 cases)by random number table.On the basis treatment of controlling blood pressure and blood glucose,patients in control group received captopril,12.5 mg/time,3 times/day.Based on the treatment of control group,patients in observation group received Tangshen 1 number decoction,1 dose/day.Course of treatment in two groups were both 12 weeks.Before and after treatment,24 hours urinary albumin excretion rate(UAER),the ratio of microalbuminuria and creatinine,fasting plasma glucose(FPG) and hemoglobin Alc were detected.Levels of total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were detected.Levels of serous t-PA and PAI-1 were also detected.And D-dimer(D-D) in plasma,platelet aggregation and plasma fibrinogen(FIB) were detected. Result: The total effective rate of curative effect in observation group was 90.91% superior to 68.18% in control group(P<0.05).After treatment,levels of UAER and ACR in observation group were lower than those in control group(P<0.01).And levels of TC,TG and LDL-C in observation group were lower than those in control group(P<0.01),but level of HDL-C in observation group was higher than in control group(P<0.01).Ievel of t-PA in observation group increased,and which was higher than in control group(P<0.01).Ievel of PAI-1 in observation group decreased,and which was lower than in control group(P<0.01).Ievel of FIB,D-D and platelet aggregation in observation group decreased, and which were lower than those in control group(P<0.01). Conclusion: Tangshen 1 number decoction can regulate the activity of t-PA or PAI-1 and reduce levels of D-D,FIB and platelet aggregation,it can also ameliorate lipid metabolism,reduce blood viscosity and UAER,there was a protection for renal function of early diabetic nephropathy.