厄贝沙坦联合活血降糖胶囊治疗早期2型糖尿病肾病

Irbesartan combined with Huoxuejiangtang capsule in treating early type-2 diabetic nephropathy

目的探究厄贝沙坦联合活血降糖胶囊治疗早期2型糖尿病肾病(DN)的临床疗效和价值,为早期2型糖尿病肾病的临床治疗提供更为有效的手段和方法。方法将96例临床确诊患有早期2型DN且血压正常的患者随机分为对照组、胶囊组和联合组,每组患者各32例。对照组仅给予常规西医基础治疗,包括降血糖、饮食控制以及体育锻炼等;在对照组治疗基础上,胶囊组再给予活血降糖胶囊进行治疗;而联合组在胶囊组的治疗基础上再给予厄贝沙坦联合治疗。于治疗12周后分别观察3组患者的临床疗效,并比较治疗前后患者空腹血糖(FPG)、尿微量白蛋白排泄率(UAER)、肾功能、血浆脂质、血液流变学以及糖化血红蛋白(HbAlc)的变化情况。结果 3组患者在治疗12周后,联合组患者治疗的总有效率为84.38%,显著高于胶囊组的62.50%和对照组的37.50%(P<0.05,P<0.001),且胶囊组的总有效率亦显著高于对照组(P<0.05);联合组和胶囊组患者的UAER、血液流变学和血浆脂质水平均较治疗前得到显著改善(P<0.05),且联合组患者的改善情况较胶囊组更为显著(P<0.05),而对照组患者治疗前后差异不具有统计学意义(P>0.05);3组患者治疗前后及治疗后各组间FPG、Hb ALc和肾功能无统计学意义(P>0.05)。结论厄贝沙坦联合活血降糖胶囊能有效改善早期2型DN患者的临床症状和血液流变学,显著降低患者血脂和尿微量白蛋白,并能改善和稳定患者肾功能,且作用效果显著优于单纯应用活血降糖胶囊。

Objective To study the clinical efficacy of irbesartan combined with Huoxuejiangtang capsule in treating early type-2 diabetic nephropathy,and apply a more efficient method for the treatment of it. Methods The 96 normal blood pressure patients confirmed with early type-2 diabetic nephropathy were divided into three groups,control group,capsule group and combination group. The patients in control group were only given conventional basic treatment,including reducing blood glucose,diet control and physical training; capsule group was given Huoxuejiangtang capsule again on the basis of control group; and combination group was given irbesartan again on the basis of capsule group. The clinical efficacy of the three groups were observed after 12 weeks,and compared the changes of fasting plasma glucose（ FPG）,urine albumin excretion ratio（ UAER）,renal function,blood fat,hemorheology,and glycosylated hemoglobin（ HbAlc）. Results The total effective rate of patients in combination group was 84. 38% and significantly higher than that in control group（ 62. 50%） and capsule group（ 37. 50%）（ P〈0. 05,P〈0. 001）,and the capsule group was also significantly higher control group（ P〈0. 05）; The UAER,hemorheology and blood fat of patients in combination group and capsule group had been significantly improved after treatment（ P〈0. 05）,and combination group was more significantly than capsule group（ P〈0. 05）,and there was no significant difference in control group before and after treatment（ P〈0. 05）; And the FPG,Hb Alc and renal function of three group was no statistically significance after treatment（ P〈0. 05）. Conclusion Irbesartan combined with Huoxuejiangtang capsule can effectively improve the clinical symptoms and hemorheology of the patient with early type-2 diabetic nephropathy,significantly reduce blood fat and microalbuminuria in urine,and can improve and stabilize the renal function of patients.And the clinical efficacy is significantly superior to applying Huoxuejiangtang capsule alone.