雷公藤多苷联合胰激肽原酶治疗糖尿病肾病的疗效观察

Therapeutic effect of Tripterygium Glycosides Combined with Pancreatic Kininogenase in Treatment of Diabetic Nephropathy

【目的】探讨雷公藤多苷联合胰激肽原酶治疗糖尿病肾病（DN）的疗效。【方法】选择2016年3月至2017年11月在本院诊治的DN患者80例，按照随机数表法为观察组和对照组。对照组给予胰激肽原酶治疗，观察组在对照组基础上联合雷公藤多苷片。比较两组患者临床疗效及治疗前后同型半胱氨酸（Hcy）、超敏c-反应蛋白（hs-CRP）、肾功能指标[（血尿素氮（BUN）、尿肌酐（UCr）和24h尿蛋白定量（UP）]、血糖指标[空腹血糖（FPG）、餐后2h血糖（2hPG）和糖化血红蛋白（HbAlc）]；观察两组治疗期间不良反应发生情况并比较。【结果】观察组总有效率为87．50％，明显高于对照组的67．50％，其差异有统计学意义（P〉0．05）；治疗后，观察组Hcy、hs-CRP、BUN、UCr、UP、FPG、2hPG及HbAlc均明显低于对照组，其差异均有统计学意义（P〈0．05）；观察组用药1个月后有1例患者丙氨酸氨基酶轻度升高，对症治疗后恢复正常；对照组未出现不良反应，两组不良反应发生率比较差异无显著性（P〉0．05）。【结论】雷公藤多苷联合胰激肽原酶治疗DN，可显著降低患者血清炎症因子及血糖水平，改善肾功能，且安全性高，值得临床推广应用。

[Objective]To investigate the therapeutic effect of tripterygium glycosides combined pancreatic kininogenase in the treatment of diabetic nephropathy. [Methods]A total of 80 patients of diabetic nephropathy who received therapy from March 2016 to Nov 2017 in our hospital were selected as research Subjects. Accord- ing to the stochastic indicator method, patients were divided into the observation group and the control group. Patients in the control group received pancreatic kininogenase treatment, while patients in the observation group received tripterygium glycosides combined with pancreatic kininogenase treatment. Clinical efficacy, lev- els of homocysteine （Hcy）, hypersensitive C-reactive protein （hs-CRP） before and after treatment, renal func- tion indicators （blood urea nitrogen-BUN, urinary creatinine-UCr and 24h urine protein quantification-UP） and blood glucose index （fasting blood glucose-FPG, 2h post-prandial blood sugar-2hPG and glycosylated hemoglo- bin-HbAlc） were compared between the two groups. The adverse reactions were also observed during treat- ment.[Results]The total effective rate of the observation group was 87.50%, which was significantly higher than that of the control group （67.50%）.The difference between the two groups was statistically significant （ P 〈0.05）. After treatment, the levels of Hcy, hs-CRP, BUN, UCr,UP,FPG,2hPG and HbAlc in the ob- servation group were significantly lower than those of the control group （ P 〈0.05）. One patient in the obser- vation group had a slight increase in alanine aminoase after 1 month of treatment, and returned to normal after symptomatic treatment. No adverse reactions occurred in the control group. There was no significant difference in the incidence of adverse reactions between the observed group and the control group （ P 〉0.05）. [Conclu- sion]Tripterygium glycosides combined with pancreatic kininogenase in the treatment of DN can significantly reduce serum inflammatory factors and blood glucose levels, improve renal function. It is safe and worthy of clinical application.