文迪雅联合欣复衡治疗糖尿病肾病的临床观察

目的:观察欣复衡(葛根素)片联合文迪雅(马来酸罗格列酮)对糖尿病肾病的治疗作用及其机制。方法:将确诊为糖尿病肾病的180例患者随机分为对照组(A组)58例,常规控制血糖及血压;治疗组(B组)60例,常规控制血糖及血压的基础上,单用口服文迪雅4 mg (每日1次);联合治疗组(C组)62例,常规控制血糖及血压并给予欣复衡片250 mg/次(每日3次),加用口服文迪雅4 mg(每日1次);均以12周为1个疗程,观察3组治疗前后的尿素氮、血肌苷,甘油三脂、胆固醇、低密度脂蛋白、高密度脂蛋白、平均动脉压、空腹血糖、餐后2 h血糖、糖化血红蛋白、24 h尿蛋白排泄率等指标的变化。结果:A组患者治疗前后各指标差异无统计学意义(P>0.05); B,C组患者治疗后与治疗前24 h尿蛋白排泄率、尿素氮、血肌苷均下降,差异有统计学意义(P<0.05),且以联合治疗组(C组)下降更为显著(P<0.05); B,C组患者治疗后与治疗前平均动脉压、空腹血糖、餐后2 h血糖、糖化血红蛋白均下降,差异有统计学意义(P<0.05),且以联合治疗组(C组)下降更为显著(P<0.05); B, C组患者治疗后与治疗前相比,甘油三脂、胆固醇、低密度脂蛋白均下降,高密度脂蛋白升高,差异有统计学意义(P<0.05),且以联合治疗组(C组)更为显著(P<0.05)。结论:文迪雅有较好的调节血脂代谢,降低尿蛋白排泄率的作用。欣复衡加用文迪雅治疗糖尿病肾病可改善肾功能及胰岛素的疗效,比单用文迪雅好,两者合用有协同作用。

Puerarin combined with avandia for diabetic nephropathy

Objective: To observe the effect and mechanism of avandia and puerarin used in combination for diabetic nephropathy. Methods: A total of 180 patients with diabetic nephropathy were randomly divided into 3 groups. The control group (58 patients, group A) were treated with routine therapy including controling the blood glucose and blood pressure, while 60 patients in group B were treated by avandia besides routine treatment of the control group. Anoter 62 cases in group C were administed with puerarin combined with avandia for 12 weeks. The indexes such as urea nitrogen, serum creatinine, triglyceride, cholesterol, low density lipoprotein, high density lipoprotein, mean arterial pressure, fasting bloodglucose, 2h plasma glucose, glycosylated hemoglobin, and 24 h urinary albumin excretion rate were tested before and after the treatment. Results: No significant differences were found in the indexes such as triglyceride, serum cholesterol,low density lipoprotein, high density lipoprotein, glycosylated hemoglobin, malonaldehyde, erythrocuprein, blood urea nitrogen, serum creatinine and 24 h urinary albumin excretion rate among the 3 groups (P>0.05). There were no significant differences in all indexes before and after the treatment in group A (P>0.05). After the treatment, 24 h urinary albumin excretion, urea nitrogen, serum creatinine, mean arterial pressure, fasting blood glucose, 2 h plasma gluose, glycosylated hemoglobin, triglyceride, serum cholesterol, low density lipoprotein decreased significant (P<0.05) while high density lipoprotein increased significant (P<0.05). Conclusion: Avandia has better effect on adjusting the blood lipid and decreasing the urinary albumin excretion rate. Puerarin combined with avandia is more effective for improving the renal function and remission of islet function than using avandia alone. Puerarin and avandia have significant synergism.