壮药复方仙草颗粒联合贝那普利治疗早期糖尿病肾病疗效及对血清IL-6、TNF-α、CRP水平的影响

Clinical Observation of Compound Xiancao Granule Combined with Benazepril in Treatment of Early Diabetic Nephropathy and Its Effect on IL-6,TNF-α and CRP

目的:观察壮药复方仙草颗粒联合贝那普利治疗早期糖尿病肾病(DN)的临床疗效及对血清IL-6、TNF-α、CRP水平的影响。方法:将76例DN患者随机分为对照组(n=38)与治疗组(n=38),对照组给予贝那普利治疗,治疗组在给予贝那普利的基础上联合壮药复方仙草颗粒治疗,比较两组临床疗效、治疗前及治疗后中医症候积分、24 h尿微量白蛋白排泄率(UAER)、血肌酐(Scr)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP),观察两组有无不良反应及并发症。结果:治疗12周后,治疗组患者治疗总有效率为86.8%,显著高于对照组的总有效率57.9%,差异有统计学意义(P<0.05);两组患者治疗后中医症候积分、UAER、Scr、IL-6、TNF-α、CRP均显著低于治疗前(P<0.05),且治疗后治疗组显著低于对照组(P<0.05);两组患者治疗后FPG、HbA1c低于治疗前(P<0.05),但治疗后治疗组与对照组相当,差异无统计学意义(P>0.05);治疗期间两组均未出现明显不良反应及并发症。结论:在不依赖于血糖控制的情况下,壮药复方仙草颗粒联合贝那普利能够进一步抑制DN患者的微炎症反应,改善肾功能,提高DN患者的临床疗效,改善中医症候,有效降低DN患者的UAER、Scr、IL-6、TNF-α、CRP,且安全性好。

Objective:To observe the clinical effect of Compound Xiancao Granule combined with benazepril in the treatment of early diabetic nephropathy(DN).Methods:A total of 76 patients with DN were divided into the treatment group(n=38)and the control group(n=38).The control group was treated with benazepril and the treatment group was treated with Xiancao Granule combined with benazepril.And then the clinical effective rate,TCM syndrome score,the 24 h urine albumin excretion rate(UAER),serum creatinine(Scr),fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1 c),interleukin-6(IL-6),tumor necrosis factor alpha(TNF-α),C-reactive protein(CRP)and adverse reactions between two groups were compared before and after treatment.Results:After 12 weeks treatment,the clinical total effective rate was 86.8%in the experimental group,significantly higher than 57.9%in the control group(P<0.05).The TCM syndrome score,UAER,Scr,IL-6,TNF-αand CRP after treatment were significantly lower than those before treatment in the two groups(P<0.05)and the treatment group’s were significantly lower than those of the control group after treatment(P<0.05).FPG and HbA1 c after treatment were lower than those before in the two groups and the treatment group’s were equivalent than those of the control group after treatment(P>0.05).There was no obvious adverse reactions and complications in the two groups during treatment.Conclusion:Without relying on glycemic control,Compound Xiancao Granule combined with benazepril can further inhibit the microinflammation of DN patients,improve the renal function,the clinical efficacy and effectively reduce UAER,Scr,IL-6,TNF-αand CRP and is relatively safe.