缬沙坦联合黄芪颗粒治疗早期糖尿病肾病的临床观察

Clinical Observation of Early Diabetic Nephropathy Treated with Valsartan and Huangqi Granules

目的观察缬沙坦联合黄芪颗粒治疗早期糖尿病肾病(DN)的临床疗效。方法将67例DN患者随机分为两组,治疗组34例,对照组33例,在基线治疗基础上,予对照组口服缬沙坦胶囊80 mg,1次/d。治疗组在对照组治疗基础上口服黄芪颗粒,4 g/次,2次/d。两组均治疗3个月。观察两组尿微量白蛋白/肌酐(m ALB/Ucr),24 h尿蛋白、尿白蛋白排泄率(UAER)、空腹血糖(FPG)、糖化血红蛋白(Hb A1c)、血清胱抑素(Cys-C)、血β_2微球蛋白(β_2-MG)、尿N-乙酰-β-D氨基葡萄糖苷酶(NAG),比较两组总体临床疗效。结果两组治疗后m ALB/Ucr、24 h尿蛋白、UAER较治疗前均有好转(P<0.05),治疗组优于对照组(P<0.05);两组治疗后糖代谢指标FPG、Hb A1c结果较治疗前均有好转(P<0.05),治疗组改善略优于对照组,但差异无统计学意义(P>0.05);两组治疗后Cys-C、β_2-MG、NAG结果较治疗前均有好转(P<0.05),治疗组优于对照组(P<0.05);治疗组总有效率优于对照组(P<0.05)。结论缬沙坦联合黄芪颗粒治疗早期DN优于单独使用缬沙坦,可有效改善肾功能与糖代谢指标。

Objective To observe the clinical efficacy on early diabetic nephropathy（ DN） treated with valsartan and huangqi granules. Methods Sixty-seven DN patients were randomized into two groups,a treatment group（ 34 cases） and a control group（ 33 cases）. On the basis of the baseline treatment,valsartan capsules were used in the control group,80 mg,once a day; huangqi granules were used on the basis of the treatment as the control group,4 g,twice a day in the treatment group. The duration of treatment was 3 months in the two groups. The levels of m ALB / Ucr,24 h PRO,UAER,FPG,Hb A1 c,Cys-C,blood β2-MG and urine NAG were observed in the two groups. The total clinical efficacy was compared between the two groups.Results After treatment,m ALB / Ucr,24 h PRO and UAER were improved as compared with those before treatment（ P < 0. 05）. The results in the treatment group were better than those in the control group（ P <0. 05）. After treatment,the results of FPG and Hb A1 c were improved as compared with those before treatment in the two groups（ P < 0. 05）. The improvements in the treatment group were slightly better than those in the control group,but without statistical significance（ P > 0. 05）. After treatment,Cys-C,blood β2-MG and urine NAG were improved as compared with those before treatment in the two groups（ P < 0. 05）. The results in the treatment group were superior to the control group（ P < 0. 05）. The total effective rate in the treatment group was better than that in the control group（ P < 0. 05）. Conclusion The combined the medication with valsartan and huangqi granules achieves the better efficacy on early DN as compared with simple application of valsartan. It effectively improves renal function and metabolic indexes.