大黄联合替米沙坦片治疗2型糖尿病肾病蛋白尿疗效观察

目的观察大黄联合替米沙坦片治疗2型糖尿病肾病的疗效。方法早期糖尿病肾病（DN）和临床期DN各40例随机分为大黄口服组（予基础治疗、替米沙坦及大黄液口服）、大黄灌肠组（予基础治疗、替米沙坦口服及大黄液灌肠）、替米沙坦组（予基础治疗及替米沙坦口服）及对照组（予基础治疗）,疗程1月。结果各组早期DN患者治疗后尿白蛋白（MA）、β2MG、NAG酶明显改善,其中大黄口服及大黄灌肠组较替米沙坦组更明显;大黄口服及大黄灌肠组临床DN患者尿蛋白定量、尿β2 MG、尿NAG酶、血Alb、BUN、Cr治疗后明显改善,替米沙坦组除尿蛋白定量、尿β2MG、尿NAG酶外,其余指标改善不明显;大黄口服及大黄灌肠组治疗后总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL-C）、血黏度下降,对照组与替米沙坦组上述指标变化不明显。结论大黄联合替米沙坦可有效降低2型糖尿病肾病蛋白尿,降低血黏度、改善血脂紊乱,保护肾功能。

Effect of Rhubarb Combined with Telmisartan Tablets on Type-2 Diabetic Nephropathy Patients

Objective：To explore the effciacy of rhubarb combined with telmisartan tablets in the type-2 diabetic nephropathy patients.Methods：The early and the clinical type-2 diabetic nephropathy（DN） patients were divided randomly into the rhubarb oral group,the rhubarb enema group,the telmisartan group and the control group.All patients were given basic treatments.Meanwhile,each group was used the corresponding therapy for 1 month.Results：The microalbuminuria,the urinary β2-microglobulin and the NAG enzyme were improved significantly in these groups.Improvements of the rhubarb oral group and the rhubarb enema group were more obvious than it of the telmisartan group.In these 2 rhubarb groups,some indices were ameliorated including the urinary protein,the urinary β2-microglobulin,the ALB,the BUN and the Cr.In the telmisartan group,these indices were not improved remarkably expect to the urinary β2-microglobulin and the urinary NAG enzyme.After treatment,the TC,the TG,the LDL-C and the blood viscosity in two rhubarb groups were decreased.However,variations of these indices of the control group and the telmisartan group were not obvious.Conclusion：Rhubarb combined with telmisartan tablets can decline effectively proteinuria,improve blood viscosity and dyslipidemia,delay renal function failure.It can protect the kidney function.