贞清方治疗老年糖尿病肾病50例

Effects of Zhenqing Prescription in the Treatment of 50 Senile Patients with Diabetic Nephropathy

目的探讨中药贞清方治疗老年糖尿病肾病(DN)的疗效。方法将98例老年2型糖尿病DN患者随机分为治疗组50例和对照组48例。两组均给予基础治疗,包括口服格列喹酮或皮下注射胰岛素,并发高血压者加用氨氯地平,并发冠心病者加用单硝酸异山梨酯。治疗组加服贞清方口服液,每次50 mL,tid,共治疗3个月。对照组加服贝那普利,每次10 mg,qd。观察两组患者治疗前后血糖、血脂、组织型纤溶酶原激活物(t-PA)及其抑制物-1(PAI-1)的活性、尿微清蛋白排泄率(UAER)、24 h尿蛋白定量、尿素氮(BUN)和肌酐(SCr)的变化。结果治疗组总有效率(86.0%)明显高于对照组(72.9%),且差异有显著性(P<0.05)。治疗组治疗后血糖明显降低,血脂、t-PA/PAI-1、UAER、尿蛋白、BUN和SCr均较治疗前明显降低(均P<0.01或P<0.05)。治疗组治疗后血糖、血脂、t-PA、PAI-1、24 h UAER、尿蛋白定量、BUN、SCr均较对照组治疗后低(均P<0.05或P<0.01)。结论贞清方可通过改善血糖和脂肪代谢、调节t-PA/PAI-1等途径有效治疗老年糖尿病DN。

Objective To probe into the therapeutic effectiveness of Zhenqing prescription （ZQP） in the treatment of senile patients with diabetic nephropathy （DN）. Methods 98 cases of type 2 diabetes mellitus with senile diabetic nephropathy were randomly divided into two groups： the trial group（ n =50） and control group（ n =48）. Patients of both groups were subjected to the same basic treatment including restriction of sodium salt ingestion, intake of high - quality low - protein diet, oral administration of gliquidone or hypodermic injection of insulin, amlodipine PO if complicated by hypertension, isosorbide mononitrate PO if complicated by coronary heart disease. Patients of the trial group were given each additionally 50 mL of ZQP oral liquid t. i. d. , while those of the control group were given each additionally 10 mg of benalapril q.d.. The course of treatment in both groups lasted 3 months. Blood glucose, blood lipids, serum tissue-plasminogen activitator （t-PA） and plasminogen activator inhibitor-1 （ PAI-1 ） activities, 24 hour urine microalbumin excretory rate （UAER） and urine protein quantity（24h UPQ）, blood urea nitrogen（BUN） and serum creatinine（SCr） in patients of both groups before and after the treatment were determined. Results The overall effective rates in patients of the trial group（86.0% ） was significantly higher than that in those of the control group（72.9% ） （ P 〈0.05）. Levels of blood glucose, blood lipids, UAER, 24h UPQ, BUN and SCr were significantcanfly lowered after the treatment in patients of the trial group （P〈0.01 or P〈0.05 ）. Besides, these parameters in patients of the trial group were also lower than the corresponding ones in patients of the control group（ P〈0.05 ）. Conclusion ZQP was shown to be effective in the treatment of diabetic nephropathy in senile patients probably by improving blood glucose and lipid metabolism as well as regulating t-PA/PAI-1 activities.