厄贝沙坦、阿司匹林、川芎嗪联合治疗早期糖尿病肾病的临床观察

Clinical Study on Irbesartan and Aspirin Combined with Tetramethylpyrazine in the Treatment of Early Diabetic Nephropathy

目的:观察厄贝沙坦、阿司匹林、川芎嗪联合治疗糖尿病肾病(DN)的疗效。方法:将75例DN患者随机分为对照组35例与治疗组40例,对照组口服厄贝沙坦150mg,阿司匹林肠溶片100mg,qd;治疗组在对照组的基础上加用川芎嗪200mg+0.9%氯化钠250mL静脉滴注,qd。14d为1个疗程,用药28d比较2组肾功能、血脂及血液流变学指标的影响情况。结果:2组治疗后血液流变学指标(全血比高、低切黏度与红细胞集聚指数)、肾功能指标(血肌酐、血尿素氮、24h尿蛋白定量)、血脂指标(血浆总胆固醇、甘油三酯)均较治疗前显著减低(P<0.05),且治疗组的下降幅度更大(P<0.05)。结论:厄贝沙坦、阿司匹林、川芎嗪3药联合使用比厄贝沙坦、阿司匹林联合使用治疗DN的疗效更好,且具有协同肾脏保护作用。

OBJECTIVE： To explore the clinical efficacy of irbesartan, enteric-coated aspirin combined with tetramethylpyrazine in the treatment of diabetic nephropathy. METHODS： 75 patients with diabetic nephropathy were randomly divided into treatment group （n=40） and control group （n=35）. Both groups were administered with 150 mg irbesartan（p.o.） and 100 mg enteric-coated aspirin （p.o.） once a day. Treatment group were additionally treated with 0.9% normal saline containing 200 mg tetramethylpyrazine once a day （i.v.gtt）. During 28 days of treatment, treatment group was compared with control group in respect of 24-h urine protein, blood lipids, blood rheology. RESULTS： After treatment, hemorheological indexes （rib, EAI）, renal function indexes（Scr,BUN,24-h urine protein） , Serum lipids（TG, TC） were decreased significantly（P〈0.05）. CONCLUSION： Irbesartan and enteric-coated aspirin combined with tetramethylpyrazine has better effect than irbesartan and enteric-coated aspirin in the treatment of diabetic nephropathy.