补肾活血方联合缬沙坦治疗2型糖尿病肾病Ⅲ期患者的效果

Effects of Bushen Huoxue decoction combined with Valsartan in treatment of patients with type 2 diabetic nephropathy stageⅢ

目的:观察补肾活血方联合缬沙坦治疗2型糖尿病肾病Ⅲ期患者的效果。方法:选取200例2型糖尿病肾病Ⅲ期患者作为研究对象,按随机数字表法分为对照组和观察组各100例。对照组给予缬沙坦胶囊治疗,观察组在对照组基础上联合补肾活血方治疗,比较两组临床疗效、治疗前后糖代谢指标[糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2hPG)]水平、促纤维化因子[肿瘤坏死因子受体1(TNFR1)、基质金属蛋白酶-9(MMP-9)、血管内皮生长因子(VEGF)]水平和治疗期间不良反应发生率。结果:观察组治疗总有效率为92.00%(92/100),高于对照组的81.00%(81/100),差异有统计学意义(P<0.05);治疗后,两组血清HbA1c、FPG、2hPG水平均低于治疗前,但组间比较,差异无统计学意义(P>0.05);治疗后,观察组血清TNFR1、MMP-9和VEGF水平均低于对照组,差异有统计学意义(P<0.05);两组治疗期间均未出现明显不良反应。结论:补肾活血方联合缬沙坦治疗2型糖尿病肾病Ⅲ期患者可提高治疗总有效率,降低促纤维化因子水平,效果优于单纯缬沙坦治疗。

Objective:To observe effects of Bushen Huoxue decoction combined with Valsartan in treatment of patients with type 2 diabetic nephropathy stage III.Methods:200 patients with type 2 diabetic nephropathy stage III were selected as the research objects,and were divided into control group and to observation group according to the random number table method,100 cases in each.The control group was treated with Valsartan capsules,while the observation group was treated with Bushen Huoxue decoction on the basis of that of the control group.The clinical efficacy,the glucose metabolism index levels[glycated hemoglobin(HbA1c),fasting blood glucose(FPG),2 h postprandial blood glucose(2hPG)],the pro-fibrotic factor levels[tumor necrosis factor receptor 1(TNFR1),matrix metalloproteinase-9(MMP-9)and the vascular endothelial growth factor(VEGF)]before and after treatment,and the incidence of adverse reactions during treatment were compared between the two groups.Results:The total effective rate of treatment in the observation group was 92.00%(92/100),which was higher than the control group of 81.00%(81/100),and the difference was statistically significant(P<0.05).After the treatment,the levels of serum HbA1c,FPG and 2hPG in the two groups were lower than those before the treatment,but there was no significant difference between the two groups(P>0.05).After the treatment,the serum levels of TNFR1,MMP-9 and VEGF in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there were no obvious adverse reactions in the two groups during the treatment.Conclusions:Bushen Huoxue decoction combined with Valsartan in the treatment of the patients with type 2 diabetic nephropathy stage III can improve the total effective rate of treatment and reduce the levels of profibrotic factors.T Moreover,it is superior to single valsartan capsules treatment.