芪葵颗粒对早期糖尿病肾病患者微量白蛋白尿及病情进展的影响

Effect of Qikui Granule on Microalbuminuria and Progress in Patients with Early Diabetic Nephropathy

目的观察芪葵颗粒对早期糖尿病患者肾病微量白蛋白尿临床疗效。方法 80例早期糖尿病肾病患者(MogensenⅢ期)按随机数字表法分为芪葵颗粒治疗组(治疗组,40例)及厄贝沙坦片治疗组(对照组,40例)。两组在基础治疗上,治疗组加用芪葵颗粒每次1包,每日3次;对照组加用厄贝沙坦片150 mg,每日1次,疗程均为1年。观察尿微量白蛋白/肌酐(UACR)、进入MogensenⅣ期病例数、肾功能[肾小球滤过率(e GFR)、BUN、SCr、胱抑素C(Cys-c)]、血糖(FBG、HbA1c)、血脂(TC、TG)、血压(SBP、DBP)及中医证候积分的变化。结果最终治疗组38例,对照组33例完成研究。治疗组疗效总有效率[86.8%(33/38)]高于对照组[60.6%(20/33),P<0.05]。治疗组中医证候疗效总有效率[84.2%(32/38)]高于对照组[45.5%(15/33),P<0.01]。与治疗前比较,治疗后两组UACR、中医证候总积分、倦怠乏力、腰膝酸软、面肢浮肿、尿浊的症状积分降低(P<0.05,P<0.01),且治疗组低于对照组(P<0.05)。两组BUN、SCr、Cys-c、eGFR、FBG、TC、TG比较,差异无统计学意义(P>0.05)。治疗组2例患者(5.3%)进入Ⅳ期,低于对照组[7例(21.2%),P<0.05]。两组患者均未见明显不良反应。结论芪葵颗粒可显著降低早期糖尿病肾病患者微量白蛋白尿水平,延缓病情进展,改善倦怠乏力、腰膝酸软、面肢浮肿、尿浊症状。

Objective To observe the effect of Qikui Granule on microalbuminuria in patients with early diabetic nephropathy（ DN）. Methods Totally 80 patients of early DN（ Mogensen Ⅲ period） were assigned to two groups according to random digital table,i. e. Qikui Granule group（ treatment group） and Irbesartan tablets treatment group（ control group）,40 cases in each group. On the basis of the routine treatment,the treatment group was treated with Qikui Granule orally,three times a day with one pack each time,while the control group was treated with Irbesartan tablets,once a day with 150 mg.The therapeutic course was one year. The urinary albumin/creatinine rate（ UACR）,renal functions（ e GFR,BUN,SCr,Cys-c）,number of patients with stage Ⅳ,blood glucose（ FBG,HbA1c）,blood lipid（ TC,TG）,blood pressure（ SBP,DBP） and the change of CM syndromes score were observed. Results Thirty-eight patients in the treatment group and 33 patients in the control group completed the study. The total effectiveness of the treatment group was higher than the control group[86. 8%（ 33/38） vs. 60. 6%（ 20/33）,P〈0. 05]. The total effective rate of CM syndromes in the treatment group was higher than the control group[84. 2%（ 32/38） vs. 45. 5%（ 15/33）,P〈0. 01]. Compared with before treatment,the level ofUACR and the score of CM syndrome,fatigue,soreness and weakness of waist and knees,face and limb edema,urine turbidity symptoms decreased in the two groups after treatment（P〈0. 05,P〈0. 01）,and those of the treatment group were lower than those of the control group（P〈0. 05）. There was no statistically significant difference between the two groups of BUN,SCr,Cys-c,eGFR,FBG,TC and TG（P〈0. 05）. Two cases（ 5. 3%） entered stage Ⅳ in the treatment group and 7 cases（ 21. 2%） in the control group,there was statistically significant differences between the two groups（P〈0. 05）. No significant adverse reactions were observed in both groups. Conclusions Qikui Granule could significantly reduce the proteinuria in patients with DN and delay the progress of the disease. Meanwhile,it could improve symptoms of fatigue,soreness and weakness of waist and knees,face and limb edema and turbid urine.