舒洛地特联合瑞格列奈治疗糖尿病肾病的临床研究

Clinical study on sulodexide combined with repaglinide in treatment of diabetic nephropathy

目的研究舒洛地特联合瑞格列奈治疗糖尿病肾病的临床疗效。方法选取2014年5月—2015年2月重庆市南岸区人民医院收治的糖尿病肾病患者200例,随机分为对照组和治疗组,每组各100例。对照组口服瑞格列奈片,0.5 mg/次,2次/d,连续使用2周后根据患者表现出来的具体症状调整用药剂量。治疗组在对照组治疗基础上口服舒洛地特软胶囊,1粒/次,2次/d。两组均连续治疗4个月。观察两组的临床疗效,同时比较治疗前后两组患者空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(Hb A1c)、体质量指数(BMI)、24 h尿蛋白、血肌酐(Scr)、尿素氮(BUN)、IL-6、IL-10、TNF-α的变化情况。结果治疗后,对照组和治疗组的总有效率分别为88.0%、96.0%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者FPG、2 h PBG、Hb A1c、24 h尿蛋白、Scr、BUN、IL-6、IL-10、TNF-α均显著降低,同组治疗前后差异有统计学意义(P<0.05);治疗后治疗组这些观察指标的改善程度优于对照组,两组比较差异有统计学意义(P<0.05);治疗后治疗组患者BMI较治疗前显著降低,对照组无明显变化,两组比较差异有统计学意义(P<0.05)。结论舒洛地特联合瑞格列奈治疗糖尿病肾病具有较好的临床疗效,可较好的控制患者的血糖水平,减轻肾脏损害,具有一定的临床推广应用价值。

Objective To investigate the clinical effect of sulodexide combined with repaglinide in treatment of diabetic nephropathy. Methods Patients （200 cases） with diabetic nephropathy in People’s Hospital in Nan’an Distract of Chongqing City from May 2014 to February 2015 were randomly divided into control and treatment groups, and each group had 100 cases. The patients in the control group were po administered with Repaglinide Tablets, 0.5 mg/time, twice daily, and the dosage adjusted according to specific symptoms of patients after 2 weeks. The patients in the treatment group were po administered with Sulodexide Soft Capsules on the basis of the control group, 1 grain/time, twice daily. The patients in two groups were treated for 4 months. After treatment, the efficacy was evaluated, and the changes of FPG, 2 h PBG, HbA1c, BMI, 24 h urine protein, Scr, BUN, IL-6, IL-10, and TNF-α in two groups before and after treatment were compared. Results After treatment, the efficacies in the control and treatment groups were 88.0% and 96.0%, respectively, and there were differences between two groups （P 〈 0.05）. After treatment, FPG, 2 h PG, HbA1c, 24 h urine protein, Scr, BUN, IL-6, IL-10, and TNF-α in two groups were significantly decreased, and the difference was statistically significant in the same group （P 〈 0.05）. After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups （P 〈 0.05）. After treatment, BMI in treatment group was significantly decreased, and there was no significant change in the control group, with significant difference between two groups （P 〈0.05）. Conclusions Sulodexide combined with repaglinide has clinical curative effect in treatment of diabetic nephropathy, and can better control the blood sugar levels, and also can relieve kidney damage, which has a certain clinical application value.