雷公藤多苷片联合复方灵芝健肾方治疗早期糖尿病肾病的临床效果

Clinical Study on Tripterygium Wilfordii Glycosides Tablets Combined with Compound Ganoderma Kidney Invigorating Method in the Treatment of Early Diabetic Nephropathy

目的:观察雷公藤多苷片联合复方灵芝健肾方治疗早期糖尿病肾病(Diabetic Nephropathy,DN)的临床疗效及其对血清炎性反应介质、肾功能及血管内皮功能的影响。方法:选取2015年4月至2016年12月邯郸市中心医院收治的早期DN患者126例作为研究对象,按随机数字表法将纳入病例分为对照组和观察组,每组63例。对照组给予基础治疗及雷公藤多苷片,观察组在对照组治疗的基础上给予复方灵芝健肾方,2组均治疗3个月。观察2组患者临床疗效,血清炎性反应介质如肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、IL-18水平,肾功能如血肌酐(SCr)、尿素氮(BUN)、尿白蛋白排泄率(UREA),血管内皮功能如一氧化氮(NO)、血管内皮生长因子(VEGF)、内皮素-1(ET-1)丙二醛(MDA)和超氧化物歧化酶(SOD)变化情况。结果:2组治疗后SCr、BUN、UREA、TNF-α、IL-6、IL-18、ET-1、MDA较本组治疗前明显降低,NO、SOD、VEGF明显升高,差异均有统计学意义(P<0.05);观察组治疗后上述指标变化更明显,差异有统计学意义(P<0.05)。观察组治疗后总有效率为92.06%,对照组治疗后总有效率为77.78%,观察组明显高于对照组,差异有统计学意义(P<0.05)。结论:雷公藤多苷片联合复方灵芝健肾方可通过改善血管内皮功能,降低血清炎性反应介质,改善肾功能,抗氧化应激作用,提高早期糖尿病肾病的临床治疗效果。

Objective： To observe the clinical effect of tripterygium wilfordii glycosides tablets combined with compound ganoderma kidney invigorating method in the treatment of early diabetic nephropathy （DN） and the influences on the level of serum inflammatory factors, renal function and the vascular endothelial function. Methods： A total of 126 cases of early DN in our hospital from April 2015 to December 2016 were selected as research subjects, and divided into the observation group and the control group according to random number table, with 63 cases in each group.The control group was given the basic treatment and tripterygium glycosides tablets, while the observation group was given compound ganoderma kidney invigorating method based on the treatment of the control group.Two groups were treated for 3 months.The clinical curative effect, the level of serum inflammatory factors （TNF-α, IL-6, IL-18）, the renal function （SCr, BUN, UREA）, the vascular endothelial function （ET-1, MDA, NO, SOD, VEGF） of two groups were observed. Results： The levels of SCr, BUN, UREA, TNF-α, IL-6, IL-18, ET-1, MDA were decreased, and the levels of NO, SOD, VEGF were increased markedly of two groups （ P 〈0.05）.The above indexes of the observation group were changed more obviously than the control group.The differences were statistically significant （ P 〈0.05）.The total effective rate of the observation group was 92.06%, while the total effective rate of the control group was 77.78%.The difference was statistically significant （ P 〈0.05）. Conclusion： Tripterygium wilfordii glycosides tablets combined with compound ganoderma kidney invigorating method can improve the vascular endothelial function and the renal function, reduce the level of serum inflammatory factors, resist oxidative stress, and improve the clinical effect of early diabetic nephropathy.