缬沙坦联合大黄治疗糖尿病肾病的临床研究

The clinical study of Rheum palmatum combined with vaisartan in treatment of diabetic nephropathy

目的探讨缬沙坦联合大黄治疗糖尿病肾病的疗效。方法将128例糖尿病肾病（DN）患者随机分为缬沙坦对照组和缬沙坦联合大黄治疗组，疗程均为6个月。结果①与治疗前比较，治疗组治疗后血清总胆固醇（TC）、血清甘油三酯（TG）明显下降（P〈0．05，P〈0．01），血清高密度脂蛋白（HDL-C）明显上升（P〈0．05），对照组上述指标变化不明显（P〉0．05）；②治疗组与对照组均能显著改善早期DN患者尿白蛋白（MA）、尿α1微球蛋白（α1，MG）、尿β2微球蛋白（β2-MG）（P〈0．05），而治疗组较对照组疗效显著（P〈0．05）。③对临床DN患者的尿蛋白定量、尿α1-MG、尿β2-MG、血白蛋白（ALB）、血尿素氮（BUN）、血肌酐（Scr），治疗组均改善显著，而对照组除尿蛋白定量、尿α1，MG、尿β2-MG改善显著外，其余指标改善均不明显。结论缬沙坦联合大黄治疗糖尿病肾病疗效确切。

Objective To study the clinical curative effect of Rheum palmatum combined with valsartan in treatment of diabetic nephropathy. Method 61 patients with early diabetic nephropathy were randomly divided into valsartan control group and rheum palmatum combined with valsartan treated group,the total course of treatment was 6 months. Results （1） After 6 months of treatment, the level of TG,TC in treated group decreased markly（P〈0. 05, P〈0.01 ）, the level of HDL-C elevated markly（P〈0. 05）in treated group, while no significant difference of TG, TC and HDL-C in control group; （2）The urinary - MA, α1 MG,β2-MG decreased significantly in both groups in early diabetic nephropathy （P〈0.05,P〈0. 01） but more significant in treated group than in control group （P〈 0. 05）;（3）For patients with clinical diabetic nephropathy,the effects of reducing proteinuria, α1 MG, β2-MG,BUN ,Scr and improving plasma ALB in the treated group were superior to those in the control group（P〈0. 05, P〈0. 01 ）, while only the levels of proteinuria, α1 MG, β2-MG decreased significantly （P〈0.05） in control group with no significant change in other parameters. Conclusions Rheum palmatum combined with valsartan is effective in treatment of diabetic nephropathy.