通心络胶囊对糖尿病肾病患者血浆内皮素的影响

目的 观察通心络胶囊对糖尿病肾病患者血浆内皮素-1(ET—1)水平的影响，以了解其对糖尿病肾病的治疗作用。方法 63例患者分为治疗组与对照组，两组均给予糖尿病饮食及低蛋白饮食，口服降血糖药或注射胰岛素治疗；根据血压水平给予钙离子拮抗剂治疗，同时对症支持治疗。治疗组在上述治疗的基础上加用通心络胶囊，每次2粒，每天3次口服。两组均经8周治疗后，观察总结疗效；检测治疗前后内生肌酐清除率(CCr)、尿白蛋白排出率(UAER)、尿β2-微球蛋白(β2-MG)、空腹血糖(FBG)、ET—1。结果 两组治疗前各项指标差异无显著性；治疗组治疗后CCr、UAER、β2-MG、ET—1、FBG有所改善，与治疗前比较，差异有显著性(P<0．05)；与对照组治疗后比较，除FBG外，各项指标差异亦有显著性(P<0．01)。结论 通心络胶囊降低糖尿病肾病患者血浆ET—1及UAER效果显著，并对肾小管一间质损伤的修复有一定促进作用；能够有效的延缓糖尿病肾病进程，改善肾功能，并有一定的辅助降血糖作用。

Effect of Tongxinluo Capsule on Plasma Endothelin in Patients with Diabetic Nephropathy

OBJECTIVE: In order to explore the therapeutic effect of tongxinluo capsule (TXLC) on diabetic nephropathy, the influence on plasma endothelin (ET-1) level of the drug was observed. METHODS: All the 63 patients enrolled were randomly divided into the treatment group and control group. They were all treated with low protein diabetic diet, oral administration of hypoglycemic or injection of insulin, calcium antagonist according to level of blood pressure and supportive symptomatic treatment. To the treated group, 2 capsules of TXLC were given additionally three times a day. The efficacy was evaluated after 8 weeks' treatment. The chief indices observed before and after treatment were endogenous creatinine clearance rate (CCr), urinary albumin excretion rate (UAER), urinary beta2-microglobulin (beta2-MG), fasting blood-glucose (FBG) and ET-1. RESULTS: Before treatment, no significant difference was shown in all the tested indices between the treated group and the control group. After treatment, levels of CCr, UAER, beta2-MG, ET-1 and FBG significantly changed in the treated group, showing significant difference as compared with those before treatment (P < 0.05). Moreover, comparison of these indices in the two groups after treatment, excepting FBG, also showed statistical significance (P < 0.01). CONCLUSION: TXLC shows obvious effect in reducing plasma ET-1 and UAER, it is definitely effective in repairing the renal tubular interstitial damage, and effectively delay the progress of diabetic nephropathy, improve the renal function, and is favorable to ameliorate hyperglycemia auxiliarily.