黄葵胶囊联合氯沙坦治疗老年糖尿病肾病的临床疗效观察

Clinical studies on effects of combination therapy with losartan and ambrette capsule on diabetic nephropathy

目的观察氯沙坦联合黄葵胶囊治疗老年糖尿病肾病的临床疗效。方法将50例老年糖尿病肾病患者按随机数字表法分为两组：氯沙坦组、氯沙坦与黄葵胶囊联合用药组，每组25例，氯沙坦组患者接受氯沙坦治疗，氯沙坦与黄葵胶囊联合用药组患者在使用氯沙坦的基础上加用黄葵胶囊治疗。观察两组患者治疗前、治疗12w后24h尿蛋白定量、尿-乙酰-β-D氨基葡萄糖苷酶（尿NAG）、尿β2微球蛋白（β2-MG）及血肌酐水平的变化情况。结果联合用药组患者治疗12w后24h尿蛋白定量、尿NAG、尿β2-MG水平与氯沙坦组比较差异均有统计学意义（P〈0．05），而12w后血肌酐水平与氯沙坦组比较差异无统计学意义（P〉0．05）；两组各自治疗前后比较发现氯沙坦组仅24h尿蛋白定量显著下降（P〈0．05），联合用药组则24h尿蛋白定量、尿NAG、尿β2-MG均显著降低（P〈0．05）。结论氯沙坦联合黄葵胶囊治疗糖尿病肾病能显著降低蛋白尿，改善肾小管功能。

Objective To investigate the clinical effects of combination therapy of losartan and Ambrette capsule on diabetic nephropathy. Methods Fifty patients with diabetic nephropathy were randomly divided into two groups, losartan and the combination group of each of 25 patients. Losartan group received losartan, combination group losartan plus Am- brette capsule. The level of 24 h urinary protein, Urine acetyl-β-D glucosaminidase （NAG）, Urine β2-microglobulin （β2-MG） and Serum creatinine was measured before and after treatment. Results The level of 24 h urinary protein, urine NAG, urine β2-MG was significantly decreased in combination group after 12-week treatment, when compared to losartan group （P〈0.05）, while serum creatinine not （P〉0.05）. In losartan group, only 24 h urinary protein decreased by losartan treatment, whilst in combination group, the levels of 24 h urinary protein, urine NAG, urine β2-MG were all decreased （P 〈 0.05）. Conclusion Combination therapy with losartan and Ambrette capsule can effectively decrease urinary protein and protect tubular function.