知柏地黄丸联合厄贝沙坦治疗糖尿病肾病的临床研究

Clinical study on Zhibai Dihuang Pills combined with irbesartan in treatment of diabetic nephropathy

目的研究知柏地黄丸联合厄贝沙坦片治疗糖尿病肾病的临床疗效。方法选取2017年7月—2018年12月上海市静安区市北医院收治的80例糖尿病肾病患者作为研究对象,采用照抽签方式将所有患者分为对照组和治疗组,每组各40例。对照组患者口服厄贝沙坦片,0.6mg/次;治疗组患者在对照组治疗的基础上口服知柏地黄丸,1丸/次,2次/d。2周为1个疗程,两组持续治疗4个疗程。观察两组患者的临床疗效,同时比较两组治疗前后的血糖水平、肾功能指标、血清炎性因子水平。结果治疗后,对照组和治疗组的总有效率分别为77.50%、95.00%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者糖化血红蛋白(HbA1c)和空腹血糖(FBG)水平显著降低,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,治疗组血糖水平明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者尿素氮(BUN)、血肌酐(Scr)、24 h尿蛋白定量(24 h pro)和尿白蛋白排泄率(UAER)水平均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组肾功能指标水平显著低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组血清炎性因子水平显著低于对照组,两组比较差异具有统计学意义(P<0.05)。结论知柏地黄丸联合厄贝沙坦片治疗糖尿病肾病具有较好的临床疗效,能够改善患者肾功能,降低血清炎性因子水平,安全性较高,具有一定的临床推广应用价值。

Objective To study the clinical effect of Zhibai Dihuang Pills combined with Irbesartan Tablets in treatment of diabetic nephropathy.Methods Patients (80 cases) with diabetic nephropathy in Shanghai Jinan District Shibei Hospital from July 2017 to December 2018 were divided into control and treatment groups by drawing lots,and each group had 40 cases.Patients in the control group were po administered with Irbesartan Tablets,0.6 mg/time.Patients in the treatment group were po administered with Zhibai Dihuang Pills on the basis of the control group,1 pill/time,twice daily.A course of treatment was 3 weeks,and patients in two groups were treated for 4 courses.After treatment,the clinical efficacies were evaluated,and the blood glucose level,renal function indexes,and the serum inflammatory factor level in two groups before and after treatment were compared.Results After treatment,the clinical efficacies in the control and treatment groups were 77.50% and 95.00%,respectively,and there was difference between two groups (P < 0.05).After treatment,the levels of HbA1c and FBG were significantly decreased,and the difference was statistically significant in the same group (P< 0.05).After treatment,the blood glucose levels in the treatment group were significantly lower than those in the control group,with significant difference between two groups (P< 0.05).After treatment,the levels of BUN,Scr,24 h pro,and UAER in two groups were significantly decreased,and the difference was statistically significant in the same group (P< 0.05).After treatment,the renal function indexes in the treatment group were significantly lower than those in the control group,with significant difference between two groups (P< 0.05).After treatment,the levels of CRP,TNF-α,and IL-6 in two groups were significantly decreased,and the difference was statistically significant in the same group (P< 0.05).After treatment,the serum inflammatory factor level in the treatment group were lower than those in the control group,with significant difference between two groups (P< 0.05).Conclusion Zhibai Dihuang Pills combined with Irbesartan Tablets has clinical curative effect in treatment of diabetic nephropathy,can improve the renal function of patients,reduce the serum inflammatory factors level,has a high safety,which has a certain clinical application value.