黄芪注射液联合精蛋白锌重组赖脯胰岛素综合治疗早期糖尿病肾病随机平行对照研究

Randomized Controlled Parallel Study of Astragalus Injection combined with Protamine Zinc and Ralto Insulin in the Treatment of Early Diabetic Nephropathy

[目的]观察黄芪注射液联合精蛋白锌重组赖脯胰岛素综合治疗早期糖尿病肾病疗效。[方法]使用随机平行对照方法,将120例住院患者按随机数字表方法随机分为两组,饮食指导、运动干预,控制血脂。对照组60例精蛋白锌重组赖脯胰岛素,胰岛素泵皮下注射给药,0.5~0.8U/kg·d^(-1),胰岛素全天给药量40%为基础量,60%为餐前剂量,早餐及晚餐前给药。治疗组60例黄芪注射液30mL+100mL生理盐水,静滴,1次/d;精蛋白锌重组赖脯胰岛素治疗同对照组。连续治疗7d为1疗程。观测临床表现、24h尿微量白蛋白、尿β2微球蛋白、微量白蛋白/尿肌酐、N-乙酰-β-D氨基葡萄糖苷酶、糖化白蛋白、血清胱抑素C、不良反应。连续治疗1疗程(21d),判定疗效。[结果]GA、Cys-C、mALB、UACR、Uβ2MG、NAG两组均有改善(P<0.01),治疗组改善优于对照组(P<0.05,P<0.01)。[结论]黄芪注射液联合精蛋白锌重组赖脯胰岛素综合治疗早期糖尿病肾病,疗效满意,无严重不良反应,值得推广。

[Objective] To observe the curative effect of astragalus injection combined with protamine zinc reconstituted insulin in the treatment of early diabetic nephropathy. [Methods] 120 hospitalized patients were randomly divided into two groups according to random digital table method by random parallel control method. Diet guidance and exercise intervention were used to control blood lipid. In the control group, 60 cases of arginine zinc were recombinant lyline insulin, the insulin pump was injected subcutaneously, 0.5 to 0.8 U/kg·d^-1, the dosage of insulin was given 40% for the whole day, 60% for pre meal dose, breakfast and before dinner. 60 cases of astragalus injection 30 mL＋saline 100 mL, intravenous drip, once a day; protamine zinc recombinant insulin lispro treatment with the same control group. The continuous treatment of 7 d was 1 courses. The clinical manifestations, microalbuminuria in 24 h urine, urinary beta 2 microglobulin, microalbumin/urinary creatinine, N-acetyl-beta-d aminoglucosidase, glycosylated albumin, serum cystatin C, and adverse reactions were observed. 1 courses of continuous treatment（21 d） were used to determine the curative effect. [Results] GA, Cys-C, mALB, UACR, Ubeta 2 MG and NAG were improved in both groups（P〈0.01）, and the improvement in treatment group was better than that in control group（P〈0.05, P〈0.01）. [Conclusion] Astragalus injection combined with arginine zinc recombinant lyrine insulin combined with the combined treatment of early diabetic nephropathy, the curative effect is satisfactory, no serious adverse reaction, it is worth popularizing.