肾康注射液联合厄贝沙坦治疗早期糖尿病肾病的临床观察

Influence of Shengkang injection with Irbesartan on trace albumin excretion and blood rheology in early diabetic nephropathy.

目的观察肾康注射液联合厄贝沙坦对早期糖尿病肾病患者24h尿白蛋白排泄率（UAER）、血脂及血流动力的影响。方法将150例血压正常的早期糖尿病肾病患者随机分为3组，均给予糖尿病知识教育、饮食控制、适量运动及常规降糖治疗，使空腹血糖控制在7．0mmol／L以下，餐后2h血糖在10．0mmol／L以下。对照组给予口服降糖药、胰岛素等常规西医治疗；肾康注射液组在对照组的基础上加用肾康注射液100ml＋5％葡萄糖注射液250ml静脉滴注，同时加2～3U胰岛素中和葡萄糖，每天1次；肾康注射液加厄贝沙坦组在肾康注射液组的基础上加用厄贝沙坦0．15g口服，1；L／d；3周为1疗程，观察9周。比较3组患者治疗前后UAER、血脂及血流动力学指标的变化。结果治疗9周后与治疗前比较，在降低患者UAER、降低血脂及改善患者血流动力方面，肾康注射液组[UAER：（87．44±10．06）μg／min与（116．55±33．42）μg／min、总胆固醇：（4．22±0．70）mmol／L与（4．88±0．69）mmol／L、全血高切黏度：（5．77±0．53）mPa·s与（7．38±0．41）mPa·s]和肾康注射液加厄贝沙坦纽[UAER：（61．90±28．02）μg／min与（123．37±29．98）μg／min、总胆固醇：（4．00±0．14）mmol／L与（4．90±0．12）mmol／L、全血高切黏度：（5．11±0．41）mPa·s与（7．27±0．44）mPa·s]疗效显著（P均〈0．05），对照组改善情况不明显；且肾康注射液加厄贝沙坦组疗效明显优于肾康注射液组（P均〈0．05）。结论肾康注射液可降低早期糖尿病肾病患者UAER、降低血脂、改善血流动力，对早期糖尿病肾病具有治疗作用，与厄贝沙坦合用可能有协同作用。

Objective To observe the influence of Shenkang injection with Irbesartan on urinary albumin excretion rate（UAER） in 24 hours, serum lipid and blood rheology in early diabetic nephropathy. Methods One hundred and fifty normotensive early diabetic nephropathy were randomly divided into control group, Shenkang injection group and Shenkang injection with Irbesartan group. Three groups were treated with diabetic education, dietary regimen, suitable physical activity and oral anti-hyperglycemic agents till their fasting blood glucose （FBG） was less than 7.0 mmol/L and postprandial blood glucose（PBG） was less than 10. 0 mmol/L. The control group was treated with oral anti-hyperglycemic agents or/and insulin. Shenkang injection group was additionally treated with Shenkang solution. Shenkang solution was mixed by Shenkang injection 100 ml,5% glucose 250 ml and insulin 2- 3 U. Shenkang solution was intravenously guttaed once a day. Shenkang injection with Irbesartan group was additionally treated with Irbesartan 0. 15 g, once a day, taken orally. A course was taken for 3 weeks. The levels of UAER, serum lipid and blood theology were detected immediately and 9 weeks after treatment. Results In the Shenkang injection group, compared with those before treatment, there were significant difference in UAER （87. 44 ± 10.06） μg/min vs. （ 116. 55 ± 33.42 ） μg/min ）, serum lipid （ （ 4. 22± 0. 70 ） mmol/L vs. （4.88± 0. 69 ） mmol/L） and blood rheology （ （ 5.77 ± 0. 53 ） mPa·s vs. （ 7.38 ± 0. 41 ） mPa·s） （ P 〈 0. 05 ）. In the Shenkang injection with lrbesartan group, compared to those before treatment, there were also significant difference in UAER （（ 61.90± 28.02） μg/min vs. （ 123.37 ±29. 98） μg/min）, serum lipid（ （4. 00 ± 0. 14） mmol/L vs. （4. 90 ± 0. 12） mmol/L） and blood rheology （ （ 5.11 ± 0. 41 ） mPa·s vs. （ 7.27 ± 0. 44 ） mPa·s） （ P 〈 0.05 ）. Whearas in the control group, no significant difference were found compared with those before treatment. Furthermore, the improvements in the Shenkang injection with Irbesartan group were better than those in the Shenkang injection group （ P 〈 0. 05）. Conclusions Shenkang injection can reduce UAER , decrease serum lipid and improve renal blood rheology. It effectively prevents diabetic nephropathy in earlier period and maybe have synergy with Irbesartan.