缬沙坦联合硫辛酸治疗糖尿病肾病Ⅲ~Ⅳ期的临床研究

Clinical Study of Valsartan Combined with Lipoic Acid in the Treatment of Diabetic Nephropathy StageⅢ-Ⅳ

目的:研究缬沙坦联合硫辛酸治疗糖尿病肾病Ⅲ~Ⅳ期的临床效果。方法:将2018年2月-2019年12月本院收治的60例糖尿病肾病Ⅲ~Ⅳ期患者依照双盲法分为两组,每组30例。对照组进行常规治疗,观察组在对照组基础上使用缬沙坦联合硫辛酸治疗。对比分析两组临床疗效,比较两组治疗前、治疗4个月后血糖、血压、尿微量蛋白排泄率、血尿酸、24 h尿蛋白定量及肝肾功能。结果:观察组总有效率高于对照组(P<0.05);两组治疗4个月后FPG、HbA1c、收缩压、舒张压、尿微量蛋白排泄率、血尿酸、24 h尿蛋白定量、AST、ALT、TBIL、血肌酐、血尿素氮水平均降低,且观察组均低于对照组,差异均有统计学意义(P<0.05)。结论:糖尿病肾病Ⅲ~Ⅳ期使用缬沙坦联合硫辛酸治疗,能积极、安全有效地保护肾功能,减轻蛋白尿,减少糖尿病的微血管病变及变化,从而使得肾脏病变减轻或延缓发展。

Objective:To study the clinical effect of Valsartan combined with Lipoic Acid in the treatment of diabetic nephropathy stageⅢ-Ⅳ.Method:A total of 60 patients with diabetic nephropathy stageⅢ-Ⅳadmitted to our hospital from February 2018 to December 2019 were divided into two groups according to the double-blind method,30 cases in each group.The control group received conventional treatment,and the observation group was treated with Valsartan combined with Lipoic Acid on the basis of the control group.The clinical effects of two groups were compared and analyzed,and the blood glucose,blood pressure,urine microprotein excretion rate,blood uric acid,and 24 h urine protein quantitative liver and kidney function of two groups before and 4 months after treatment were studied.Result:The total effective rate of the observation group was higher than that of the control group(P<0.05).At 4 months after treatment,FPG,HbA1c,systolic blood pressure,diastolic blood pressure,urine microprotein excretion rate,blood uric acid,24-hour urine protein quantification,AST,ALT,TBIL,blood creatinine and blood urea nitrogen levels of two groups were reduced,and the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).Conclusion:The treatment of diabetic nephropathy stageⅢ-Ⅳwith Valsartan combined with Lipoic Acid can actively,safely and effectively protect renal function,reduce proteinuria,and reduce microvascular lesions and changes in diabetes,thereby reducing or delaying the development of renal lesions.