金水宝片+厄贝沙坦治疗早期糖尿病肾病的临床价值探讨

The clinical value of Jinshuibao tablets combined with irbesartan in the treatment of early diabetic nephropathy

目的探讨早期糖尿病肾病(DN)应用金水宝片+厄贝沙坦治疗的临床价值。方法94例早期糖尿病肾病患者,以随机数字表法分为联合组与对照组,每组47例。对照组仅予以厄贝沙坦治疗,联合组予以金水宝片+厄贝沙坦治疗。比较两组患者临床疗效,治疗前后肾功能指标[血肌酐(SCr)、尿素氮(BUN)、胱抑素C(Cys C)],治疗后尿白蛋白排泄率(UAER)、尿微量白蛋白水平;分析两组患者不良反应发生情况。结果联合组临床治疗总有效率为87.23%(41/47),显著高于对照组的70.21%(33/47),差异具有统计学意义(χ^(2)=4.065,P<0.05)。治疗后,两组患者的SCr、BUN与Cys C水平均低于治疗前,且联合组患者的SCr(75.94±11.36)μmol/L、BUN(6.35±1.26)mmol/L、Cys C(1.38±0.45)mg/L低于对照组的(86.08±14.21)μmol/L、(7.56±1.37)mmol/L、(2.04±0.39)mg/L,差异具有统计学意义(P<0.05)。联合组治疗后的UAER为(47.43±5.22)mg/24 h、尿微量白蛋白为(115.28±9.58)mg/L,均低于对照组的(68.74±5.84)mg/24 h、(156.46±13.72)mg/L,差异具有统计学意义(t=18.651、16.871,P=0.000、0.000<0.05)。治疗期间两组患者仅出现几例轻度头晕、恶心与心悸,不良反应症状轻微,多于服药后几个小时内消失。结论早期糖尿病肾病患者应用金水宝片+厄贝沙坦治疗可有效改善肾功能、降低尿白蛋水平,具有确切的临床疗效,值得临床推荐。

Objective To discuss the clinical value of Jinshuibao tablets combined with irbesartan in the treatment of early diabetic nephropathy(DN).Methods A total of 94 patients with early diabetic nephropathy were divided into a combination group and a control group according to the random numerical table,with 47 cases in each group.The control group was treated with irbesartan only,and the combination group was treated with Jinshuibao tablets and irbesartan.Both groups were compared in terms of clinical efficacy,renal function indexes[serum creatinine(SCr),blood urea nitrogen(BUN),cystatin C(Cys C)],urinary albumin excretion rate(UAER)and urinary microalbumin level before and after treatment.The occurrence of adverse reactions in the two groups was analyzed.Results The total clinical treatment efficiency of the combination group was 87.23%(41/47),which was significantly higher than 70.21%(33/47)of the control group,and the difference was statistically significant(χ^(2)=4.065,P<0.05).After treatment,the SCr,BUN and Cys C levels in both groups were lower than those before treatment in this group;the SCr(75.94±11.36)μmol/L,BUN(6.35±1.26)mmol/L and Cys C(1.38±0.45)mg/L in the combination group were lower than(86.08±14.21)μmol/L,(7.56±1.37)mmol/L and(2.04±0.39)mg/L in the control group;the differences were statistically significant(P<0.05).After treatment,the UAER(47.43±5.22)mg/24 h and urinary microalbumin(115.28±9.58)mg/L in the combination group were lower than(68.74±5.84)mg/24 h and(156.46±13.72)mg/L in the control group,and the differences were statistically significant(t=18.651,16.871;P=0.000,0.000<0.05).Only a few cases of mild dizziness,nausea and palpitations occurred in both groups during treatment,and the symptoms of adverse reactions were mild and mostly disappeared after a few hours after taking the drug.Conclusion The treatment of Jinshuibao tablets and irbesartan in patients with early diabetic nephropathy can effectively improve renal function and reduce urinary protein levels.It has a definite clinical effect,and is worthy of clinical recommendation.