黄葵胶囊联合依拉普利对早期糖尿病肾病胰岛素敏感性、肾功能及微炎症状态的影响

Effects of Huangkui Capsule (黄葵胶囊) and Enalapril on Insulin Sensitivity, Renal Function and Microinflammatory State in Patients with Early Diabetic Nephropathy

目的探讨黄葵胶囊联合依拉普利治疗早期糖尿病肾病的临床效果。方法以随机数字表法,将2018年1月—2019年9月收治的104例早期糖尿病肾病患者分为对照组和观察组,每组52例,两组均给予基础治疗,对照组加用依拉普利,观察组在对照组基础上给予黄葵胶囊。观察两组治疗效果,治疗前、治疗8周后胰岛素敏感性、肾功能、微炎症状态变化及不良反应发生情况。结果观察组治疗总有效率为96.15%(50/52),与对照组82.69%(43/52)对比,明显较高(P<0.05);治疗前,两组胰岛素抵抗指数(HOMA-IR)、胱抑素-C(Cys-C)、β2-微球蛋白(β2-MG)对比,差异无统计学意义(P>0.05),治疗8周后,相较于同期对照组,观察组上述指标水平明显较低(P<0.05);治疗前,两组超敏C反应蛋白(hs-CRP)、白介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)对比,差异无统计学意义(P>0.05),治疗8周后,相较于同期对照组,观察组上述指标水平明显较低(P<0.05);观察组不良反应发生率为13.46%(7/52),与对照组9.62%(5/52)对比,差异无统计学意义(P>0.05)。结论黄葵胶囊联合依拉普利治疗早期糖尿病肾病,效果显著,可有效改善患者胰岛素敏感性、肾功能,减轻微炎症状态,且安全性高,值得推广。

Objective To explore the clinical effect of Huangkui Capsule (黄葵胶囊) combined with enalapril in the treatment of early diabetic nephropathy. Methods A total of 104 patients with early diabetic nephropathy admitted from Jan 2018 to Sep 2019 were divided into control group (52 cases) and observation group (52 cases) by the random number table method. Both groups were given basic treatment. The control group was added enalapril. The observation group was given Huangkui Capsule on the basis of the control group. The treatment effects, the changes of insulin sensitivity, renal function, microinflammatory state before and 8 weeks after treatment and adverse reaction of the two groups were observed. Results In the observation group, the total effective rate was 96.15% (50/52). It was significantly higher compared with 82.69% (43/52) in the control group (P<0.05). Before treatment, there was no significant difference in homeostasismodel assessment-insulin resistance index (HOMA-IR), cystatin-C (Cys-C) or β2-microglobulin (β2-MG) between the two groups (P>0.05). 8 weeks after treatment, compared with the control group in the same period, the levels of the above indicators in the observation group were significantly lower (P<0.05). Before treatment, there was no significant difference in high-sensitivity C-reactive protein (hs-CRP), interleukin-1 (IL-1) and tumor necrosis factor-α (TNF-α) between the two groups (P>0.05). 8 weeks after treatment, compared with the control group in the same period, the levels of the above indicators in the observation group were significantly lower (P<0.05). In the observation group, the incidence of adverse reactions was 13.46% (7/52). It had no significant difference compared with 9.62% (5/52) in the control group (P>0.05). Conclusion Huangkui Capsule combined with enalapril has significant effects on early diabetic nephropathy. It can effectively improve insulin sensitivity, renal function and reduce microinflammatory state, and has a high safety. It is worthy of promoting.