黄苓解毒泄浊颗粒灌肠联合前列地尔静注治疗糖尿病肾病患者肾功能不全的效果

The effect of retention enema with Huang Ling Jiedu Granule combined with alprostadil in the treatment of diabetic nephropathy with renal insufficiency

目的探讨黄苓解毒泄浊颗粒保留灌肠联合前列地尔治疗糖尿病肾病(DN)肾功能不全的疗效。方法 80例符合入组条件的DN致慢性肾脏病(CKD)2~4期患者按照入组顺序随机分为对照组(40例)和观察组(40例)。两组患者均给予降糖降压等常规治疗,对照组在此基础上给予前列地尔注射液(10μg加入100m L的0.9%氯化钠注射溶液中静滴,每天1次),观察组在对照组基础上加用黄苓解毒泄浊颗粒保留灌肠(每次30~60 min,每天1次)。治疗4周后,比较两组临床疗效及治疗前后尿素氮(BUN)、血肌酐(SCr)、尿微量白蛋白肌酐比值(ACR)及肾小球滤过率(e GFR)的变化。结果治疗4周后,总有效率方面,对照组为62.5%,观察组为90.0%,两组患者总有效率比较有统计学意义(χ~2=10.912,P=0.012);对照组及观察组BUN、SCr、ACR较治疗前均有不同程度降低,差异有统计学意义(P<0.05),观察组较对照组降低更明显(P<0.05)。对照组及观察组GFR较治疗前均有不同程度升高,差异有统计学意义(P<0.05);观察组较对照组升高更显著(P<0.05)。结论黄苓解毒泄浊颗粒保留灌肠联合前列地尔治疗DN致CKD 2期~CKD 4期,能很好地改善肾功能、减少尿蛋白排泄。

Objective To explore the effect of retention enema with Huang Ling Jiedu Granule combined with alprostadil in the treatment of diabetic nephropathy （DN） with renal insufficiency. Methods A total of 80 DN patients with chronic kidney disease （2 -4 stage） were collected and randomly divided into the control group （40 cases） and the observation group （40 cases）. Two groups of patients were given conventional hypoglycemic and antihypertensive treatment, the control group were given Alprostadil Injection （ 10 g into normal saline 100 mL intravenous drip, 1 times a day treatment） ,observation group were given Alprostadil Injection combined with Huang Ling Jiedu Xiezhuo granule re- tention enema （ more than 30 minutes each time, 1 times a day）. The clinical efficacy; the changes of urea nitrogen （ BUN ） , serum creatinine （SCr） , urinary albumin/urinary creatininc （ACR） and glomerular filtration rate （GFR） were compared between the two groups after 4 weeks. Results After 4 weeks, the total effective rate of control group was 62. 5% , and the observation group was 90%, there were statistically significant （ P 〈 O. 05 ）. The BUN, SCr and ACR of two groups were reduced compared to the baseline, the difference was statistically significant （P 〈 O. 05 ） , the observation group decreased more than the control group（P 〈0.05）. The GFR of two groups were increased compared to baseline, the difference was statistically significant（ P 〈 0.05 ）, and the observation group was more than the control group （P 〈 0. 05 ）. Conclusion Retention enema with Huang Ling Jiedu Granule combined with alprostadil in DN with CKD （ 2 - 4 stage） can improve renal function and reduce urinary protein excretion.