肾炎康复片联合缬沙坦治疗Ⅳ期糖尿病肾病蛋白尿的临床研究

Clinical study of Shenyankangfu tablet combined with valsartan capsule on proteinuria in patients with stage Ⅳ diabetic nephropathy

目的 探讨肾炎康复片联合缬沙坦治疗肾功能正常Ⅳ期糖尿病肾病患者蛋白尿的临床疗效.方法 将厦门市第二医院2009年-2012年就诊的120例肾功能正常Ⅳ期糖尿病肾病患者,随机数字表法分为单纯缬沙坦组、肾炎康复片联合缬沙坦组,两组患者各60例,均常规予以限制饮食,控制血糖、血压,调节血脂等基础治疗;此外,单纯缬沙坦组予以缬沙坦160 mg/次、每天1次,肾炎康复片联合缬沙坦组予以肾炎康复片5片/次、每天3次,联合缬沙坦160 mg/次、每天1次,治疗16周后,检测两组患者的24 h尿白蛋白定量、血肌酐、血糖、血脂等水平.结果 治疗16周后肾炎康复片联合缬沙坦组临床疗效总有效率66.7％,高于单纯缬沙坦组（46.7％）,差异有统计学意义（P＜0.05）.治疗后两组患者24h尿白蛋白定量均较治疗前明显下降,肾炎康复片联合缬沙坦组尿白蛋白定量明显低于单纯缬沙坦组,差异有统计学意义[（1.77 ±0.79） g vs.（2.29±1.36）g,t=2.617,P＜0.05].两组患者血肌酐、血糖等指标与治疗前相比差异无统计学意义（P均＞0.05）.结论 肾炎康复片联合缬沙坦治疗比单用缬沙坦更能有效降低肾功能正常Ⅳ期糖尿病肾病患者的蛋白尿.

Objective To investigate the therapeutic effects of Shenyankangfu tablet combined with valsartan capsule on proteinuria in patients with stage Ⅳ diabetic nephropathy and normal renal function.Methods 120 patients with stage Ⅳ diabetic nephropathy and normal renal function were randomly divided into two groups：valsartan group（n =60,valsartan 160 mg qd） and valsartan combined with Shenyankangfu tablets group （n =60,Shenyankangfu tablet 5 tablets tid combined with Valsartan 160 mg qd）,and were treated for 16 weeks.Both groups were treated with the same basic diet control and routine treatment.After 16-week course of treatment,24 hours urinary protein,serum creatinine,blood glucose and blood lipids were determined and compared.Results Mter 16-week treatment,the total efficiency of the experiment group and the control group was 66.7% and 46.7% respectively,there was a significant difference between the two groups （P 〈 0.05）.The 24 hours urinary protein of both groups after treatment were significantly decreased,but in valsartan combined with Shenyankangfu tablets group,the 24 hours urinary protein decreased greatly [（1.77 ± 0.79） g vs.（2.29 ± 1.36） g,t =2.617,P 〈 0.05].The levels of serum creatinine and blood glucose of both groups had no significant differences before and after treatment（P 〉 0.05）.Conclusion Shenyankangfu tablet combined with Valsartan capsule can decrease the urinary protein in patients with stage Ⅳ diabetic nephropathy,the therapeutic effect is better than valsartan alone.