ARB制剂联合雷公藤多甙治疗糖尿病肾病

目的探讨ARB制剂联合雷公藤多甙治疗糖尿病肾病大量蛋白尿的疗效及其安全性。方法将65例糖尿病肾病患者分为联合治疗组(传统治疗基础上加用缬沙坦和雷公藤多甙片)和对照组(传统治疗基础上加用缬沙坦)。治疗前及治疗后3、6个月分别检测24 h尿蛋白定量、血白蛋白、肾功能、肝功能、血脂、血常规等并进行比较。结果①联合治疗组治疗6月后显效19例,有效9例,无效4例,总有效率为87%。对照组治疗6个月后显效2例,有效18例,无效9例,总有效率为68%,联合组总有效率高于对照组(P<0.05)。②联合组治疗前及治疗后3、6个月尿蛋白定量、血浆白蛋白比较均有显著性差异(P<0.01,P<0.05),随着时间推移,24 h尿蛋白定量逐渐减少,血浆白蛋白逐渐升高;对照组治疗前及治疗后3、6月尿蛋白定量、血浆白蛋白比较均有显著性差异(P<0.05),随着时间推移,24 h尿蛋白定量逐渐减少,血浆白蛋白逐渐升高;同一时间点联合治疗组和对照组相比较亦有显著性差异(P<0.01,P<0.05)。结论 ARB制剂联合雷公藤多甙治疗糖尿病肾病大量蛋白尿有较好的疗效,对患者的肝、肾功能及外周血象未见明显不良影响。

ARB combined with tripterygium glycosides regimen for treatment of patients with diabetic nephropathy

Objective To explore the effect and safety of ARB combined with tripterygium glycosides regimen for treatment of patients with diabetic nephropathy.Methods 68 diabetic nephropathy patients were randomly divided into combined therapy group(valsartan plus tripterygium glycosides) and control group(valsartan).All patients were given basic treatments.The serum creatinine(SCr),urea nitrogen(BUN),albumin,blood fat,and 24h urinary protein were measured in time points of before the treatment,3 months and 6 months after treatment.Results ① Compaired with control group,total effective rate in combined therapy group was significantly increased(P<0.05) after 6 months.The excellence case,effective case and useless case in combined therapy were 19 patients,9 patients and 4 patients.② In both of 2 groups,there were significant differences in 24h urinary protein,albumin(P<0.01,P<0.05) in 3,6 months after operation.However,in combined therapy group,24h urinary protein and albumin increased obviously(P<0.01,P<0.05).Conclusion ARB combined with tripterygium glycosides regimen can effectively decline protein urinary,cause less adverse effect on liver and kidney functions as well as hemogram.