诺和龙和尿毒清联合依帕司他治疗糖尿病肾病疗效观察

Efficacy of the combination of Epalrestat, Novolin and Niaoduqing in the treatment of diabetic nephropathy

目的观察诺和龙和尿毒清联合依帕司他治疗糖尿病肾病的临床疗效。方法选择广州市增城区人民医院2016年6月至2018年6月收治的120例糖尿病肾病患者进行研究,根据随机数表法均分为对照组和观察组,每组60例。对照组采取诺和龙和尿毒清治疗,观察组采取诺和龙和尿毒清联合依帕司他治疗,治疗疗程为3个月。比较两组患者治疗后的疗效、血压、肾功能指标和不良反应发生情况,以及治疗前和治疗后的C-反应蛋白(hs-CRP)、白细胞介素6 (IL-6)、肿瘤坏死因子α(TNF-α)水平。结果观察组患者的治疗总有效率为96.67%,明显高于对照组的83.33%,差异有统计学意义(P<0.05);治疗3个月后,观察组患者的舒张压(DBP)、收缩压(SBP)、血肌酐(SCr)、24 h尿微量白蛋白排泄率(UMER)、尿素氮(BUN)水平均明显低于对照组,差异均有统计学意义(P<0.05);治疗前,两组患者的hs-CRP、IL-6和TNF-α比较差异均无统计学意义(P>0.05);治疗3个月后,观察组患者的hs-CRP、IL-6和TNF-α水平分别为(1.57±0.47) mg/L、(24.93±3.78)μg/L和(15.91±3.16)μg/L,均明显低于对照组的(4.79±0.58) mg/L、(38.71±4.23)μg/L和(20.18±3.79)μg/L,差异均具有统计学意义(P<0.05);对照组和观察组患者的不良反应总发生率分别为6.67%、8.33%,差异无统计学意义(P>0.05)。结论诺和龙和尿毒清联合依帕司他治疗糖尿病肾病能够改善患者的血压、肾功能,减少炎症,改善预后,临床治疗效果显著,值得推广应用。

Objective To observe the clinical efficacy of Novolin and Niaoduqing combined with Epalrestat in the treatment of diabetic nephropathy. Methods A total of 120 patients with diabetic nephropathy, who admitted to Zengcheng People’s Hospital of Guangzhou from June 2016 to June 2018, were selected and divided into the control group and observation group according to the random number table method, with 60 cases each group. The control group was treated with Novolin and Niaoduqing, while the observation group was treated with Novolin and Niaoduqing combined with Epalrestat. The curative effect, blood pressure and renal function indexes of the two groups after 3 months of treatment, the levels of C-reactive protein(hs-CRP), interleukin-6(IL-6), tumor necrosis factor-alpha(TNF-α) and adverse reactions before and after 3 months of treatment were compared and analyzed. Results The total effective rate of the observation group(96.67%) was significantly higher than that of the control group(83.33%), and the difference between the two groups was statistically significant(P<0.05). After 3 months of treatment, the levels of diastolic blood pressure(DBP), systolic blood pressure(SBP), serum creatinine(SCr), 24-hour urinary microalbumin excretion rate(UMER), and urea nitrogen(BUN) in the observation group were significantly lower than those in the control group(P<0.05). Before treatment, there was no significant difference in hs-CRP, IL-6 and TNF-alpha between the two groups(P>0.05). After 3 months of treatment, hs-CRP, IL-6 and TNF-alpha in the observation group were(1.57 ± 0.47) mg/L,(24.93±3.78)μg/L,(15.91±3.16)μg/L, respectively, which were significantly lower than corresponding(4.79±0.58) mg/L,(38.71±4.23)μg/L,(20.18±3.79)μg/L in the control group(P<0.05). The total incidence of adverse reactions in the control group and the observation group were 6.67% and 8.33%, respectively, with no significant difference(P>0.05).Conclusion In the treatment of diabetic nephropathy, Novolin and Niaoduqing combined with Epalrestat can improve blood pressure, renal function, reduce inflammation and improve prognosis. The clinical effect is remarkable, and it is worth popularizing and applying.