AngⅡ受体拮抗剂联合复方活血散治疗糖尿病肾病的疗效分析

An analysis of the effect of angiotensin Ⅱ receptor antagonist combined with Fufanghuoxuesan on diabetic nephropathy

目的观察血管紧张素(Ang)受体拮抗剂联合复方活血散(三七、红花、水蛭、川芎、生地、赤芍、甘草)治疗糖尿病肾病的疗效和对肾功能的保护作用。方法47例糖尿病肾病患者进入该项研究,其血糖均控制在理想水平,血压基本恒定。随机分为治疗组24例,对照组23例,两组降压、降糖等治疗相仿,治疗组加用Ang受体拮抗剂替米沙坦80 mg,每天1次。结果治疗8周后,治疗组尿蛋白为(1.97±0.60)g/d,与治疗前的(3.12±1.20)g/d相比明显下降(P<0.01)与对照组的(3.11±1.35)g/d比较,差异有显著性(P<0.01);对照组血肌酐为(225.5±26.6)μmol.L-1,与治疗前的(177.3±22.8)μmol.L-1相比明显上升(P<0.01),与治疗组的(115.6±34.2)μmol.L-1比较,差异有显著性(P<0.01)。结论Ang受体拮抗剂联合复方活血散治疗糖尿病肾病具有降低尿蛋白、保护肾功能的作用。

Objective To investigate the effects of Angiotensin Ⅱ receptor antagonist combined with Fufanghuoxuesan on proteinuria in patients of diabetic nephropathy and its protection of renal function. Methods 47 patients whose blood-sugar level is satisfactorily controlled and whose blood pressure is held constant are chosen for the study. They are randomly put into two groups, one of which is 24 and the other, 23, with the former as the treatment group and the latter as the control. Both of the groups receive similar therapy to control their blood pressure and plasma glucose while the treatment group additionally takes a dosage 80 mg of Angiotension Ⅱ receptor antagonist Telmisartan per day. Results 8 weeks later, the mean proteinuria level in the treatment group drops from （3.12 ± 1.20） g/d to （1.97 ±0.60） g/d, which indicates not only a sharp decline （P〈0.01） when compared with that before treatment but also a significant difference （P〈0.01） when compared with that of the control group （3.11±1.35） g/d. Meanwhile, the blood creatinine of the control group rises from （177.3±22. 8） μmol.L^-1 to （225.5 ±26.6）μmol.L^-1, which indicates not only a sharp increase （P〈0. 01） when compared with that before treatment but also a significant difference （P〈0.01） when compared with that of the treatment group （3. 11 ± 1. 35） g/d. Conclusion Angiotensin receptor antagonist combined with Fufangbuoxuesan can definitely decrease proteinuria and protect renal function.