黄葵胶囊联合雷公藤多苷片治疗Ⅳ期糖尿病肾病疗效观察

目的观察黄葵胶囊联合雷公藤多苷片治疗Ⅳ期糖尿病肾病的疗效。方法选取2011年7月至2015年7月Ⅳ期糖尿病肾病患者270例，并随机分为三组，各90例。对照组A患者予血管紧张素Ⅱ受体拮抗剂（ARB）治疗；对照纽B患者加用黄葵胶囊治疗；观察组患者另加黄葵胶囊与雷公藤多苷片进行治疗。治疗12周后比较三组患者的治疗效果。结果在治疗12周时，三组患者血白蛋白、血肌酐、内生肌酐清除率均无明显变化。对照组B与观察组患者24h尿蛋白定量均有所改善，对照组B患者24h尿蛋白定量（18±0．8）g／24h；观察组患者24h尿蛋白定量为（1．0±0．7）g／24h，与治疗前比较，差异有统计学意义（P〈0．05）。观察组患者改善效果优于对照组B，差异有统计学意义（P〈0．05）。对照组A患者无不良反应，对照组B患者发生不良反应6例（6．7％），观察组患者发生不良反应18例（20．O％），与对照组A比较，差异有统计学意义（P〈005）。结论治疗Ⅳ期糖尿病肾病，采用黄葵胶囊与雷公藤多苷片联合的方法效果良好，能延缓肾病进展，应在临床推广使用。

Objective To explore the effect of abelmosk capsule and tripterygium glycosides tablet in the treatment of patients with diabetic nephropathy IV. Methods 270 patients with diabetic nephropathy Ⅳ treatment in our hospital from July 2011 to July 2015 were selected and divided into three groups, the 90 cases of control group A were treated with ARB, the 90 cases of control group B were treated with abelmosk capsule, the 90 cases of observation group in treatment ofabelmosk capsule and tripterygium glycosides tablet. The clinical parameters and effect of 3 groups＇ patients were compared. Results At 12 weeks of treatment, no significant change was found in serum albumin, serum creatinine, creatinine clearance rate of the 3 groups. The 24 hour urine protein quantitative improvement was observed in the control group B and observation group, the control group B patients 24 hours urinary protein quantitative was （ 1.8 ± 0.8 ） Hg/24, the observation group of patients with 24 hours urine protein quantitative was （ 1.0 ± 0.7 ） Hg/24, compared with before treatment, the difference was statistically significant （P〈0.05） .The improvement effect of the observation group was better than that of the control group B, the difference was statistically significant （ P〈0.05 ） between the 2 groups. No adverse reaction was found in the control group, the total incidence of adverse reactions in the control group wos 6 （ 6.7% ） , the total incidence of adverse reactions in the observation group was 18 （ 20% ） , and the difference was statistically significant （ P〈0.05 ） compared with control group A. Conclusion In the treatment of diabetic nephropathy IV, abelmosk capsule and tripterygium glycosides tablet have a good effect to delay the progression of renal disease and should be popularized in clinical practice.