通心络胶囊联合津力达颗粒对Ⅳ期糖尿病肾病患者尿蛋白、肾功能的影响

Observation on Efficacy of Tongxinluo Capsules Combined with Jinlida Granules in Improving Urine Protein and Renal Function of Patients with Stage IV Diabetic Nephropathy

目的:探讨通心络胶囊联合津力达颗粒对Ⅳ期糖尿病肾病患者尿蛋白、肾功能的影响。方法:选取2017年3月至2018年3月儋州市人民医院收治的Ⅳ期DN患者82例作为研究对象,按照随机数字表法分为对照组和观察组,每组41例,分别给予厄贝沙坦和津力达颗粒+通心络胶囊治疗,观察患者肾功能、血液流变学指标等改善情况。结果:经治疗,观察组全血高、低切黏度及血浆黏度、纤维蛋白原、血细胞比容均显著低于对照组,差异有统计学意义(t=19.234、15.070、2.977、5.270、17.181,P<0.05),血肌酐(Scr)、尿素氮(BUN)、肌酐清除率(Ccr)、血清内皮素-1(ET-1)和24 h尿蛋白定量(24-UP)也均显著低于对照组,差异有统计学意义(t=14.008、3.514、10.308、2.640、20.044,P<0.05);观察组治疗后C反应蛋白(CRP)、胱抑素-C(Cys-C)水平均显著低于对照组,差异有统计学意义(t=34.151、12.212,P<0.05);2组不良反应发生率分别为7.32%、4.88%,差异无统计学意义(χ^2=0.213,P>0.05)。结论:给予Ⅳ期DN患者通心络胶囊联合津力达颗粒治疗,可使患者肾功能、尿蛋白获得更好改善,且可降低炎性反应递质水平,提高总体疗效。

Objective:To explore clinical efficacy of Jinlida Granules combined with Tongxinluo Capsules in the treatment for patients with stage IV diabetic nephropathy(DN).Methods:From March 2017 to March 2018,82 cases of stage IV DN admitted in Danzhou People′s Hospital were selected as study objects.According to random number table method,they were divided into control group(n=41)and observation group(n=41).They were given irbesartan and Jinlida Granules+Tongxinluo Capsules respectively.Improvement of indexes in renal function and hemorheology was observed.Results:After the treatment,whole blood high and low shear viscosities and plasma viscosity,fibrinogen and hematocrit in the observation group were significantly lower than those in the control group(t=19.234,15.070,2.977,5.270,17.181,P<0.05);Scr,BUN,Ccr,ET-1 and 24-UP were also significantly lower than those in the control group(t=14.008,3.514,10.308,2.640,20.044,P<0.05);after the treatment,levels of CRP and Cys-C in the observation group were significantly lower than those in the control group(t=34.151,12.212,P<0.05);the incidences of adverse reactions in the 2 groups were 7.32%and 4.88%respectively,and there was no significant difference(χ^2=0.213,P>0.05).Conclusion:Applying Tongxinluo Capsules combined with Jinlida Granules in patients with stage IV DN can better improve renal function and urine protein of them,and reduce the level of inflammatory factors.It is helpful to effectively improve the overall efficacy in patients.