前列地尔、缬沙坦、肾消方三者联合治疗糖尿病肾病的疗效及对肾功能的影响

Efficacy of combination of alprostadil, valsartan and shenxiao prescription in the treatment of diabetic nephropathy and their effect on renal function

目的探讨前列地尔、缬沙坦及肾消方联合治疗糖尿病肾病的疗效及对肾功能的影响。方法选取2017年3月~2018年3月我院住院治疗的糖尿病肾病100例。全部患者根据治疗方法不同分为观察组和对照组,每组50例,两组患者均予控制饮食、运动及皮下注射胰岛素等方法将血糖控制在正常水平。两组均予“肾消方”。对照组患者予缬沙坦胶囊80 mg,每天1次,治疗4周;观察组同时加用前列地尔注射液10 μg 静注,每天1次,连续治疗4周。治疗后比较两组的临床疗效以及两组患者治疗前后Scr、BUN、UAER水平的变化情况。结果治疗后,观察组患者显效率64.0%、无效率4.0%,总有效率96.0%,对照组患者显效率 40.0%、无效率22.0%,总有效率78.0%,两组临床疗效比较差异具有显著性(P<0.05)。治疗前,观察组患者的Scr、BUN、UAER水平与对照组比较,差异无显著性(P>0.05),治疗后,观察组患者的Scr 为(121.6±28.0)μmol/L、BUN为(8.7±1.9)mmol/L、UAER水平为(86.1±12.9)mg/24 h,对照组患者的Scr为(180.6±13.9)μmol/L、BUN为(11.5±2.2)mmol/L、UAER水平为(174.3±16.5)mg/24 h,观察组患者上述各指标分别显著低于对照组,组间比较差异有显著性(P<0.05)。结论前列地尔、缬沙坦及肾消方联合治疗糖尿病肾病疗效确切,且能明显改善患者的肾功能,值得临床推广和应用。

Objective To discuss the efficacy of combination of alprostadil, valsartan and Shenxiao prescription in the treatment of diabetic nephropathy and their effect on renal function. Methods 100 patients with diabetic nephropathy hospitalized in our hospital from March 2017 to March 2018 were selected and divided into observation group and control group according to different treatment methods, 50 cases in each group. Both groups of patients were given controlled diet, exercise and subcutaneous injection of insulin to control blood glucose at normal levels. Both groups were given Shenxiao prescription. The control group was given valsartan capsule 80 mg once daily for 4 weeks. The observation group was given 10 μg of alprostadil injection once a day for 4 weeks. After treatment, the clinical efficacy of the two groups and the changes of Scr, BUN and UAER levels before and after treatment in the two groups were compared. Results After treatment, the observation group showed a significant effective rate of 64.0%, ineffective rate of 4.0%, and a total effective rate of 96.0%. The control group had a significant effective rate of 40.0%, ineffective rate of 22.0%, and a total effective rate of 78.0%. The difference in clinical efficacy between the two groups was significant(P<0.05). Before treatment, the Scr, BUN, and UAER levels in the observation group were not significantly different from those in the control group (P>0.05). After treatment, the Scr of the observation group was(121.6±28.0)μmol/L, BUN was (8.7±1.9)mmol, and the level UAER was(86.1±12.9)mg/24 h, and the Scr of the control group was(180.6±13.9)μmol/L, BUN was(11.5±2.2)mmol/L, and UAER level was(174.3±16.5) mg/24 h. The above indexes of the observation group were significantly lower than those of the control group, and the differences between the groups were significant(P<0.05). Conclusion The combination of alprostadil, valsartan and Shenxiao prescription is effective in the treatment of diabetic nephropathy, and can significantly improve the renal function of patients, which is worthy of clinical promotion and application.