基于重复测量方差分析观察黄葵胶囊联合氯沙坦钾治疗糖尿病肾脏病Ⅲ期的临床疗效

Clinical efficacy of Huangkui capsule combined with losartan potassium in the treatment of diabetic kidney disease stageⅢby using repeated measurement analysis of variance

目的采用重复测量方差分析探讨黄葵胶囊联合氯沙坦钾治疗糖尿病肾脏病Ⅲ期的临床疗效。方法采用随机数字表法将糖尿病肾脏病Ⅲ期患者分为试验组(n=43)与对照组(n=43)。所有患者均接受相同的基础治疗,对照组患者给予氯沙坦钾治疗,试验组患者在对照组的基础上加用黄葵胶囊。于治疗前、治疗后4周、治疗后8周、治疗后12周分别测量2组患者的24 h尿微量白蛋白定量(24 h urinary protein,Upro)、尿肾损伤分子-1(urinary kidney injury molecule-1,UKim-1)以及尿β_(2)-微球蛋白(urinaryβ_(2)-microglobulin,Uβ_(2)-MG)水平;比较治疗前及治疗后12周2组患者中医临床证候积分差异。结果重复测量方差分析结果显示,2组患者的Upro、Uβ_(2)-MG的时间效应、组间效应和交互效应差异均具有统计学意义(P<0.05),2组患者的UKim-1只有时间效应具有统计学意义(P<0.05)。单因素重复测量方差分析结果表明试验组患者与对照组患者Upro以及Uβ_(2)-MG水平随治疗时间变化趋势不同。多变量方差分析结果显示:试验组治疗后4周、治疗后8周以及治疗后12周的Upro水平均低于对照组(P<0.05);试验组治疗后8周以及治疗后12周的Uβ_(2)-MG水平低于对照组(P<0.05)。治疗12周后试验组中医临床证候积分低于对照组(P<0.05)。结论黄葵胶囊联合氯沙坦钾治疗糖尿病肾脏病Ⅲ期疗效优于单纯使用氯沙坦钾治疗。

Objective To explore the clinical effect of Huangkui capsule combined with losartan potassium in the treatment of diabetic kidney disease stageⅢby using repeated measurement analysis of variance(ANOVA).Methods Patients with stageⅢdiabetic kidney disease were divided into the experimental group(n=43)and the control group(n=43)by random number table method.All patients received the same basic treatment,the control group was given losartan potassium treatment,and the experimental group was treated with Huangkui capsule be sides the treatment in the control group.The 24-hour urinary protein(Upro),urinary kidney injury molecule-1(Ukim-1),and Urinaryβ_(2)-microglobulin(Uβ_(2)-MG)were measured before the treatment,4 weeks after the treatment,8 weeks after the treatment,and 12 weeks after the treatment in both groups,and the difference of TCM clinical syndrome scores between the two groups was evaluated before the treatment and 12 weeks after the treatment.Results The results of repeated measurement ANOVA showed that the time effect,inter group effect and interaction effect of Upro and Uβ_(2)-MG in the two groups were statistically significant(P<0.05),and only the time effect of Ukim-1 in the two groups was statistically significant(P<0.05).The results of one-way repeated measurement ANOVA showed that the levels of Upro and Uβ_(2)-MG in the experimental group and the control group had different trends with the treatment time.The results of multivariate analysis of variance showed that the level of Upro in the experimental group was lower than that in the control group at 4 weeks,8 weeks and 12 weeks after the treatment(P<0.05).The level of Uβ_(2)-MG in the experimental group at 8 weeks and 12 weeks after the treatment was lower than that in the control group(P<0.05).After 12 weeks of the treatment,the TCM clinical syndrome score in the experimental group was significantly lower than that in the control group(P<0.05).Conclusion Huangkui capsule combined with losartan potassium is superior to losartan potassium alone in the treatment of stageⅢdiabetic kidney disease.