尿毒清颗粒辅助治疗早期糖尿病肾病的临床观察

Clinical Observation of Niaoduqing Granules in the Treatment of Early Diabetic Nephropathy

目的:观察尿毒清颗粒辅助治疗早期糖尿病肾病(DN)的临床疗效。方法:选取我院133例早期DN患者,随机分成两组,对照组(65例)给予常规西药方案治疗(采用血管紧张素Ⅱ受体拮抗药类或血管紧张素转换酶抑制剂类降压药物控制尿蛋白),治疗组(68例)在对照组治疗基础上加用尿毒清颗粒每次5.0g,每日4次。两组患者均治疗24周。比较治疗前后两组患者的肾功能指标[内生肌酐清除率(Ccr)、尿微量白蛋白(MA)、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、血清胱抑素C(CysC)]、肝功能指标[血清白蛋白(ALB)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、血红蛋白(Hb)]、血脂指标[总胆固醇(TC)、甘油三酯(TG)]等的变化,并记录不良反应。结果:治疗组患者总有效率为83.8%,对照组患者总有效率为60.0%,两组比较差异有统计学意义(P<0.05);治疗组治疗后CysC、MA均较治疗前显著下降,Ccr较治疗前显著上升(P<0.05或P<0.01),而对照组治疗后仅Ccr较治疗前显著上升(P<0.05);两组患者其他指标治疗前、后比较差异均无统计学意义(P>0.05)。两组患者均未见严重不良反应发生。结论:早期DN患者在常规西药治疗基础上加用尿毒清颗粒治疗效果明显,可显著降低患者的CysC和MA水平,改善肾小球滤过功能,且安全性较好。

OBJECTIVE：To observe the clinical efficacy of Niaoduqing granules in the treatment of early diabetic nephropathy（DN）.METHODS：133 patients with early DN of our hospital were randomized into 2 groups.65 cases of control group were given conventional therapy of western medicine（controlling urine protein by angiotensin Ⅱ receptor antagonists or angiotensin converting enzyme inhibitor）.68 cases of treatment group were additionally given Niaoduqing granules 5.0 g 4 times a day on the basis of control group for 24 weeks.The changes of hepatic function index（Ccr,MA,HbA1c,FPG,Cys C）,hepatic function index（ALB,ALT,AST,Hb） and blood lipid index（TC,TG） were compared between 2 groups before and after treatment;ADR were also recorded.RESULTS：Total effective rate of treatment group was 83.8%,and that of control group was 60.0%,there was statistical significance between 2 groups（P0.05）;Cys C and MA of treatment group decreased significantly after treatment,while Ccr level increased significantly（P0.05 or P0.01）;there was no statistical significance in other index between 2 groups before and after treatment（P0.05）.No severe ADR was found in 2 groups.CONCLUSIONS：Niaoduqing granules are effective in the treatment of early DN,can significantly reduce Cys C and MA and improve glomerular filtration function with sound safety.