还原型谷胱甘肽联合黄芪注射液对早期糖尿病肾病尿白蛋白排泄率及C反应蛋白的影响

Effect of combined therapy with reduced glutathione and astragalus membranaceus injection on urinary album in excretion rate and C-reactive protein in patients with early diabetic nephropathy

目的 观察还原型谷胱甘肽（GSH）联合黄芪注射液治疗对糖尿病肾病患者尿白蛋白排泄率（UAER）及C反应蛋白（CRP）水平的影响.方法 将59例2型早期糖尿病肾病患者,完全随机分为对照组（29例）和研究组（30例）,经3周治疗后,观察24 h尿蛋白、UAER和CRP水平的变化.结果 2组治疗后24 h尿蛋白、UAER、CRP均较治疗降低[研究组分别为（0.5±0.3） g/24 h比（0.9±0.2） g/24 h,（58±32） μg/min比（92±36） μg/min,（2.4±0.5）g/L比（4.7±1.6） g/L,对照组分别为（0.7±0.2） g/24 h比（0.9±0.2）g/24 h,（74±294） μg/min比（94±39） μg/min,（3.1±0.7）g/L比（4.6±1.6）g/L],差异均有统计学意义（P＜0.01）,研究组较对照组降低更明显（P＜0.05）.2组治疗后血清肌酐、BUN较治疗前均有下降,差异有统计学意义（P＜0.05）,治疗后2组间比较,差异无统计学意义（P＞0.05）.结论 GSH联合黄芪注射液治疗明显降低早期糖尿病肾病患者UAER及CRP的水平,减低肾脏损伤程度,改善肾脏功能,较单用黄芪注射液作用明显.

Objective To observe the effect of combined therapy of reduced glutathione（GSH） and astraga- lus membranaceus injection on the levels of urinary album in excretion rate （UAER） and C-reactive protein （CRP） in early diabetic nephropathy. Methods Fifty-nine patients with early diabetic nephropathy were randomly assigned to the control group treated by astragalus membranaceus injection alone, and the observation group treated by GSH and astragalus membranaceus injection for 3 weeks. The changes of 24 hours urinary protein quantity, UAER, creatinine （Cr）, urea nitrogen （BUN） and CRP levels were measured before and after treatment to estimate the protective effect of the combined therapy. Results Levels of 24 h urinary protein, UAER and CRP were all decreased after treatment in both groups[ observation group was（0. 5±0. 3 ） g/24 h vs （0. 9±0. 2） g/24 h, （58 ± 32）μg/min vs （92±36） μg/min, （2.4±0. 5）g/L vs （4.7±1.6）g/L,control group was （0.7±0. 2）g/24 h vs （0.9±0. 2）g/24 h, （74 ±294） μg/min vs （94± 39 ） μg/min, （ 3.1±0. 7 ） g/L vs （4. 6±1.6 ） g/L ], showing significant differences compared with those before treatment （ P 〈 0. 01 ） , and the reduction in the observation group was more significant （ P 〈 0.05） ; meanwhile, levels of serum Cr and BUN had also decreased significantly compared with those before treatment（ P 〈 0. 05 ）, showing no statistical difference between the two groups after treatment （ P 〉 0. 05 ）. Conclusions Combined use of GSH and astragalus membranaceus injection could significantly lower the UAER and CRP levels in patients with early diabetic nephropathy to alleviate the renal impairment, showing a higher effect compared with using astragalus membranaceus injection alone. GSH combined with astragalus membranaceus injection is safer, more effective and reliable than astragalus membranaceus injection alone in the treatment of DN.