丹参多酚酸盐在糖尿病肾病治疗中的临床研究

Clinical study of salvia miltiorrhiza in the treatment of diabetic nephropathy

目的:观察丹参多酚酸盐改善糖尿病肾病(DN)患者抗氧化及肾功能的临床效果。方法:将90例DN患者随机分为治疗组和对照组,每组45例,2组均给予降糖降压等基础治疗,对照组口服氯沙坦钾片治疗,50mg,qd;治疗组给予静脉注射丹参多酚酸盐,200mg,qd,2组均治疗2周。检测并比较2组治疗前后血糖、肾功能及氧化应激指标水平,观察治疗期间药物不良反应发生情况。结果:治疗后对照组有效率为73.33%(33/45),治疗组为91.11%(41/45),2组间治疗有效率差异有统计学意义(P<0.05)。治疗后2组血肌酐(Scr)、24h尿蛋白(24h Upro)、尿素氮(BUN)、胱抑素C(CysC)、尿蛋白排泄率(UAER)、β2微球蛋白(β2-MG)等肾功能指标与治疗前比较均降低(P<0.05),且治疗组上述各项肾功能指标改善程度明显优于对照组(P<0.05)。治疗后2组血清活性氧(ROS)、丙二醛(MDA)与治疗前比较均降低,超氧化物歧化酶(SOD)均升高(P<0.05),且治疗组上述各项氧化应激指标改善程度均显著高于对照组(P<0.05),2组治疗前后血糖水平无明显变化(P>0.05)。2组不良反应发生率比较无明显差异(P>0.05)。结论:丹参多酚酸盐可显著改善DN患者氧化应激及肾功能指标,疗效确切,安全性高。

OBJECTIVE To observe the effect of salvia miltiorrhiza on the improvement of antioxidant and renal functions in diabetic nephropathy（DN）patients.METHODS Ninety patients with DN were randomly divided into treatment group and control group,45 patients in each group.Patients in the 2 groups were given basic treatment such as reducing blood sugar and blood pressure,patients in the control group were treated with oral losartan potassium tablets,50 mg,q.d.;patients in the treatment group were given intravenous injection of salvia miltiorrhiza,200 mg,q.d.All patients were treated for 2 weeks.The blood sugar,renal functions and the indexes of oxidative stress before and after treatment in the 2 groups were detected and compared,and the incidence of adverse drug reactions during treatment was observed.RESULTS After treatment,the effective rate was 73.33%（33/45）in the control group,91.11%（41/45）in the treatment group,and the difference between the 2 groups was significant（P0.05）.After treatment,the renal function indexes,such as serum creatinine（Scr）,24 hurine protein（24 h Upro）,blood urea nitrogen（BUN）,cystatin C（Ccr）,Urinary protein excretion rate（UAER）andβ2-microglobulin（β2-MG）in the 2 groups decreased compared with those before treatment（P0.05）,the improvement of the renal function indexes in the treatment group was obviously better than those in the control group（P0.05）.After treatment,the reactive oxygen species（ROS）and malondialdehyde（MDA）of the 2 groups were lower than those before treatment,and the superoxide dismutase（SOD）increased（P0.05）,the improvement degree of the indexes of oxidative stress in the treatment group was obviously superior to those in the control group.There was no significant change in blood glucose levels before and after treatment in 2 groups,or in the incidence of adverse reactions between the 2 groups（P0.05）.CONCLUSION Salvia miltiorrhiza can significantly improve the oxidative stress and renal function in patients with DN,and has high efficacy and safety.