雷公藤多苷治疗糖尿病肾病并蛋白尿的疗效观察

Observation on the therapeutic effect of tripterygium glycosides in treatment of diabetic nephropathy and proteinuria

目的:探讨雷公藤多苷治疗糖尿病肾病蛋白尿期的疗效及治疗前后炎性因子水平,初步探讨其机制。方法:2014年1-7月收治糖尿病肾病蛋白尿期患者40例,按照数字随机法分为观察组和对照组各20例。对照组给予常规降血糖药物治疗,试验组在常规治疗的基础上给予雷公藤多苷片。用药10周后,比较两组患者治疗前后蛋白尿缓解情况以及肾功能、肿瘤坏死因子(TNF-α)、C反应蛋白(CRP)水平变化。结果:观察组完全缓解5例,有效10例,无变化5例;对照组完全缓解1例,有效3例,无变化16例;观察组24 h蛋白尿缓解率高于对照组,差异具有统计学意义(P<0.05)。观察组24 h尿微量白蛋白、BUN、Scr较治疗前显著降低(P<0.05),与对照组治疗后比较差异有统计学意义(P<0.05)。观察组TNF-α、CRP较治疗前显著降低(P<0.05),且显著低于对照组(P<0.05)。结论:雷公藤多苷可降低糖尿病肾病患者体内炎性反应,减少24 h尿蛋白,且不良反应较小。

Objective:To investigate the efficacy of tripterygium glycosides treated on albuminuria stage of diabetic nephropathy,and its inflammatory factor levels before and after treatment,in order to preliminary study of its mechanism.Methods:40 patients with albuminuria stage of diabetic nephropathy were selected from July 2014 to January 2014.They were randomly divided into the observation group and the control group with 20 cases in each.Patients in the control group were given conventional hypogl ycemic drug treatment,while in the observation group were given tripterygium glycosides tablet on the basis of conventional therapy.After treated for 10 weeks,we compared the remission of proteinuria and renal function,tumor necrosis factor(TNF- a),and C reactive protein(CRP) level change in two groups before and after the treatment.Results:In the observation group,there were 5 cases of complete remission,10 cases of effective,and 5 cases had no change;while in the control group,there was 1 cases of complete remission,3 cases of effective,and 16 cases had no change;proteinuria remission rate within 24 h of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).The urinary albumin,BUN and Scr in 24 h of the observation group had decreased significantly than before the treatment(P<0.05),and also had statistically significant differences when compared with the control group after treatment(P<0.05).After the treatment,the TNF-alpha and CRP of the observation group had decreased significantly than before the treatment(P<0.05),and also significantly lower than the control group(P<0.05).Conclusion:Tripterygium glycosides can reduce the inflammatory reaction in patients with diabetic nephropathy,and decrease urinary protein within 24 h,and it also has less adverse reactions.