肾炎康复片联合舒洛地特治疗肾病综合征合并类固醇糖尿病疗效及对β2-MG、CRP、HCY水平的影响

Effect of Nephritis Rehabilitation Tablet(肾炎康复片)Combined with Sulodexter in Treatment of Nephrotic Syndrome with Steroid Diabetes and Its Effect onβ2-MG,CRP and HCY

目的探讨肾炎康复片联合舒洛地特治疗肾病综合征合并类固醇糖尿病的疗效及对β2-MG、CRP、HCY水平影响。方法选取医院治疗的84例肾病综合征合并类固醇糖尿病炎患者,随机分为两组各42例。对照组患者给予舒洛地特,治疗组在对照组基础上口服肾炎康复片,两组患者均持续治疗6个月。对比两组患者的临床疗效、中医症候积分、Scr、ALB、BUN、24 h UPE水平、2 h PG、FBG、HbA1c和FINS水平、β2-MG、CRP、HCY水平、补体C3、IgG和CD^(+)_(4)/CD^(+)_(8)水平。结果治疗后,治疗组总有效率较高(P<0.05);两组患者治疗前中医证候积分差异无统计学意义(P>0.05);两组患者治疗后腰脊酸痛、疲倦乏力、面浮肢肿、肢体困重等证候评分显著降低(P<0.05);并且治疗组腰脊酸痛、疲倦乏力、面浮肢肿、肢体困重评分明显低于对照组(P<0.05);两组患者治疗前Scr、ALB、BUN、24 h UPE水平差异无统计学意义(P>0.05);两组患者治疗后Scr、BUN、24 h UPE显著降低,ALB水平明显升高(P<0.05);并且治疗组改善较多(P<0.05);两组患者治疗前2 h PG、FBG、HbA1c和FINS水平差异无统计学意义(P>0.05);两组患者治疗后2 h PG、FBG、HbA1c和FINS水平显著降低(P<0.05);并且治疗组2 h PG、FBG、HbA1c明显低于对照组(P<0.05),治疗组患者FINS水平低于对照组,但但差异无统计学意义(P>0.05);两组患者治疗前β2-MG、CRP、HCY水平差异无统计学意义(P>0.05);治疗后两组患者β2-MG、CRP、HCY水平显著降低(P<0.05);并且治疗组降低较多(P<0.05);两组患者治疗前补体C3、IgG和CD^(+)_(4)/CD^(+)_(8)水平差异无统计学意义(P>0.05);对照组患者治疗前后补体C3、IgG和CD^(+)_(4)/CD^(+)_(8)水平变化无统计学意义(P>0.05);治疗组患者治疗后补体C3、IgG和CD^(+)_(4)/CD^(+)_(8)水平高于对照组,但差异无统计学意义(P>0.05)。结论采用肾炎康复片联合舒洛地特治疗肾病综合征合并类固醇糖尿病具有较好的治疗效果,能够改善血清β2-MG、CRP、HCY水平,安全性较高,值得在临床上推广应用。

Objective To investigate the effect of Nephritis Rehabilitation Tablet(肾炎康复片)combined with sulodexter in the treatment of nephrotic syndrome with steroid diabetes and its effect on levels ofβ2-MG,CRP and HCY.Methods A total of 84 patients with nephrotic syndrome and steroid diabetes mellitus were randomly divided into two groups.Patients in the control group were given sulodexter,and those in the treatment group were given Nephritis Rehabilitation Tablet orally on the basis of the control group.Patients in both groups continued treatment for 6 months.Clinical efficacy,TCM syndrome scores,levels of Scr,ALB,BUN,24 h UPE levels,2 h PG,FBG,HbA1 c and FINS,levels of 2-MG,CRP and HCY,levels of complement C3,IgG and CD^(+)_(4)/CD^(+)_(8)were compared between the two groups.Results After treatment,the total effective rate was higher in the treatment group(P<0.05).There was no difference in the scores of TCM symptoms between the two groups before treatment(P>0.05).The syndrome scores of patients in the two groups were significantly reduced(P<0.05).In addition,the scores of lumbar spinal pain,fatigue,facial buoyancy and limb distress in the treatment group were significantly lower than those in the control group(P<0.05).There was no difference in Scr,ALB,BUN or 24 h UPE between the two groups before treatment(P>0.05).After treatment,Scr,BUN and 24 h UPE were significantly reduced and ALB level was significantly increased in the two groups(P<0.05).In addition,the treatment group showed more improvement(P<0.05).There was no difference between the two groups in PG,FBG,HbA1 c or FINS 2 h before treatment(P>0.05).After treatment,the levels of PG,FBG,HbA1 c and FINS in the two groups were significantly reduced at 2 h(P<0.05).Moreover,the FINS level of the treatment group was lower than that of the control group at 2 h(P<0.05),and the FINS level of the treatment group was lower than that of the control group,but the difference was not statistically significant(P>0.05).Before treatment,there was no difference in 2-mg,CRP and HCY levels between the two groups(P>0.05).After treatment,levels ofβ2-MG,CRP and HCY were significantly reduced in the two groups(P<0.05).In addition,there was a significant decrease in the treatment group(P<0.05).There was no significant difference in the levels of C3,IgG or CD^(+)_(4)/CD^(+)_(8)before treatment between the two groups(P>0.05).After treatment,the levels of C3,IgG and CD^(+)_(4)/CD^(+)_(8)in the control group were not statistically significant(P>0.05).After treatment,the levels of C3,IgG and CD^(+)_(4)/CD^(+)_(8)in the treatment group were higher than those in the control group,but the difference was not statistically significant(P>0.05).Conclusion The combination of Nephritis Rehabilitation Tablet and sulodexter in the treatment of nephrotic syndrome with steroid diabetes has a good therapeutic effect and can improve the serum levels ofβ2-MG,CRP and HCY.