骨化三醇胶丸联合氯沙坦钾治疗糖尿病肾病的临床研究

Clinical study on Calcitriol Soft Capsules combined with losartan in treatment of diabetic nephropathy

目的探讨骨化三醇胶丸联合氯沙坦钾治疗糖尿病肾病的临床疗效。方法选取2014年4月—2016年1月天津市第二医院收治的糖尿病肾病患者120例,随机分为对照组和治疗组,每组各60例。两组患者均给予运动和饮食控制指导,并口服降糖药物控制血糖。对照组患者口服氯沙坦钾片,起始剂量为25 mg/次,1次/d,根据耐受情况可逐渐调整至50 mg/d。治疗组在对照组的基础上口服骨化三醇胶丸,1粒/次,1次/d。两组患者均持续治疗3个月。观察两组患者临床疗效,同时比较两组治疗前后肾功能相关指标、炎性因子水平变化情况。结果治疗后,对照组和治疗组总有效率分别为75.00%、90.00%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者24 h尿蛋白量、UAER、Scr、TNF-α、hs-CRP和IL-6水平均显著降低,同组治疗前后差异具有统计学意义(P<0.05);且治疗组上述观察指标降低更明显,两组比较差异有统计学意义(P<0.05)。结论骨化三醇胶丸联合氯沙坦钾用于治疗糖尿病肾病具有显著的临床疗效,能够降低蛋白尿水平,并能减轻炎症反应,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacies of Calcitriol Soft Capsules combined with losartan in treatment of diabetic nephropathy. Methods Patients（120 cases） with diabetic nephropathy in Tianjin Second Hospital Selected from April 2014 to Janurary 2016 were randomly divided into control group and treatment group, and each group had 60 cases. All patients were given exercise and diet control guidance, and were po administered with hypoglycemic drugs to control blood sugar. The patients in the control group were po administered with Losartan Potassium Tablets, 25 mg/time as initial dosage, once daily, and which was gradually adjusted to 50 mg/d according to the different tolerance. The patients in the treatment group were po administered with Calcitriol Soft Capsules on the basis of control group, 1 grain/time, once daily. The patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and the changes of renal function indexes and inflammatory factors levels before and after treatment in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 75.00% and 90.00%, respectively, and there were differences between two groups（P〈0.05）. After treatment, 24 h urinary protein, UAER, Scr, TNF-α, hs-CRP and IL-6 levels were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. And these observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups（P〈0.05）. Conclusion Calcitriol capsules combined with losartan in treatment of diabetic nephropathy has a significant clinical efficacy, can reduce the proteinuria levels in urine and inflammatory reaction, which has a certain clinical application value.