金水宝胶囊联合雷米普利治疗早期糖尿病肾病临床观察

Clinical Observation of Ramipril Combined with Jinshuibao Capsule in the Treatment of Early Diabetic Nephropathy

目的探究雷米普利联合金水宝胶囊治疗早期糖尿病肾病的临床疗效。方法收集2016年6月—2019年3月期间于医院诊治的138例早期糖尿病肾病患者为研究对象,随机分成对照组与治疗组(每组69例)。对照组予以雷米普利片口服治疗,治疗组在对照组治疗基础上予以金水宝胶囊口服。两组均连续治疗2个月。观察两组治疗后临床疗效,并比较治疗前后两组的氧化应激、炎症反应、内皮功能、血脂指标、尿素氮(BUN)、血清肌酐(Cr)、24h尿蛋白定量(24h-UTP)值、尿白蛋白排泄率(UAE)水平、肾动脉血流参数变化情况。结果治疗后,治疗组有效率(91.30%)明显高于对照组(72.46%),两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清BUN、Cr、24hUTP、UAE水平均明显下降(P<0.05),且治疗组较对照组降低更为显著(P<0.05)。治疗后,两组患者外周血中性粒细胞与淋巴细胞比值(NLR)、C反应蛋白(CRP)、内皮素(ET)-1、低密度脂蛋白胆固醇(LDL-C)、血清三酰甘油(TG)水平均明显下降(P<0.05),血清超氧化物歧化酶(SOD)、降钙素基因相关肽(CGRP)水平明显提高(P<0.05),且两组比较,治疗组改善更为显著(P<0.05)。治疗后,两组肾动脉血流参数RI、PI值明显降低(P<0.05),且治疗组降低更为显著(P<0.05)。结论雷米普利联合金水宝胶囊治疗早期糖尿病肾病可显著对肾功能起保护作用,降低患者尿蛋白大量排泄,改善血管内皮功能,调节脂质代谢紊乱状态,提高机体抗氧化能力,减轻体内微炎症反应严重程度,对肾脏血流动力学有积极调节作用,疗效明显。

Objective To explore the clinical effect of ramipril combined with Jinshuibao capsule in the treatment of early diabetic nephropathy.Methods 138 cases of early diabetic nephropathy treated in our hospital from June 2016 to March 2019 were randomly divided into control group and treatment group(69 cases in each group).The control group was treated with ramipril tablet,and the treatment group was treated with Jinshuibao Capsule on the basis of the control group.Two groups of patients were treated for 2 months.The changes of oxidative stress,inflammatory response,endothelial function,blood lipid index,BUN,Cr,24 h-utp,UAE and renal artery blood flow parameters were compared before and after treatment.Result after treatment,the effective rate of the treatment group(91.30%)was significantly higher than that of the control group(72.46%).The difference between the two groups was statistically significant(P<0.05).After treatment,the levels of bun,Cr,24 h-utp and UAE in the two groups were significantly decreased(P<0.05),and the level in the treatment group was significantly lower than that in the control group(P<0.05).After treatment,the ratio of neutrophils to lymphocytes(NLR),C-reactive protein(CRP),endothelin(ET)-1,low-density lipoprotein cholesterol(LDL-C)and serum triglyceride(TG)decreased significantly(P<0.05),and the levels of superoxide dismutase(SOD)and calcitonin gene-related peptide(CGRP)increased significantly(P<0.05)The improvement of the treatment group was more significant(P<0.05).After treatment,RI and Pi of renal artery blood flow parameters in the two groups were significantly reduced(P<0.05),and the decrease in the treatment group was more significant(P<0.05).Conclusion ramipril combined with Jinshuibao capsule in the treatment of early diabetic nephropathy can significantly protect the renal function,reduce the large amount of urinary protein excretion,improve the vascular endothelial function,regulate the disorder of lipid metabolism,improve the antioxidant capacity of the body,reduce the severity of micro inflammatory reaction in the body,have a positive regulatory effect on renal hemodynamics,and have a significant effect.