中西医结合治疗对尿微量白蛋白排泄的影响

目的观察以血管紧张素转换酶抑制剂（ACEI）加益气养阴、活血化瘀中药对非肾脏疾病早期肾损害患者尿微量白蛋白排泄的影响.方法入选糖尿病伴早期糖尿病肾病、高血压病及冠心病伴早期肾损害三组患者195例,再将各组随机分为二个亚治疗组,分别给予ACEI及ACEI加中药治疗.结果糖尿病组、高血压病组及冠心病组患者24 h尿微量白蛋白排泄量（UAE）高于正常老年对照组（P＜0.01）,亚组1经ACEI治疗后,尿微量白蛋白排泄率（UAER）均有不同程度下降（P＜0.01或P＜0.05）.亚组2经ACEI加中药治疗后,UAER比亚组1降低（P＜0.05）.结论 ACEI加益气养阴、活血化瘀中药能有效减少糖尿病肾病、高血压病及冠心病早期肾损害患者尿蛋白排出,延缓肾损害进展,中西医结合治疗效果优于单纯ACEI治疗.

Effects of integrated traditional Chinese and western medicinal treatment on microalbuminuria

Objective The purpose of this study was to investigate the effects of combined treatment of angiotensin-converting enzyme inhibition (ACEI) and traditional Chinese medicine of supplementing-Qi nourishing-Yin and activating blood circulation to remove blood stasis on mi-croalbuminuria in early kidney injury patients without kidney disease. Methods 195 patients with diabetes accompanied by early diabetic nephropathy, or with hypertension or coronary heart disease accompanied by early kidney injury were selected. Each of these three groups was further divided into two subgroups randomly and ACEI or ACEI with traditional Chinese medicine was given. Results Twenty-four-hour urinary albumin excretion (UAE) of patients with diabetes, or hypertension, or coronary heart disease was higher than that of normal old people(P < 0.01). UAER of subgroup 1 treated with ACEI was decreased(P < 0.01 or P < 0.05). UAER of subgroup 2 treated with ACEI and traditional Chinese medicine was significantly lower than that of subgroup l(P < 0.05). Conclusion ACEI combined with traditional Chinese medicine of supplementing-Qi nourishing-Yin and activating blood circulation to remove blood stasis could effectively decrease UAE and delay the development of kidney injury in patients with diabetes accompanied by early diabetic nephropathy, or with hypertension or coronary heart disease accompanied by early kidney injury. Our research indicated that integrated traditional Chinese and western medical treatment was better than single ACEI treatment.