糖肾葆颗粒联合依那普利片对早期糖尿病肾病肾功能的保护作用

Protection Study of Tangshenbao Granules Combined with Enalapril Maleate Tablets in Treating Patients with Early Diabetic Nephropathy

摘要:

目的: 观察糖肾葆颗粒联合依那普利片对早期糖尿病肾病(DN)的临床疗效及机制作用. 方法: 80例DN患者采用分层区组随机分为对照组和联合组各40例.两组严格控制血糖,采用氨氯地平片,5~10 mg/次,1次/d,口服,控制血压.对照组服用依那普利片,10 mg/次,1次/d.联合组在对照组治疗的基础上采用糖肾葆颗粒(配方颗粒),1剂/d,分2次口服.两组疗程均为12周.检测尿微量白蛋白与肌酐比值(mALB/Ucr)、尿白蛋白排泄率(UAER)、空腹血糖(FPG)、糖化血红蛋白(HbAlc)、血清胱抑素(Cys-C)、血β₂微球蛋白(β₂-MG)、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)和肾损伤分子-1(KIM-1).治疗前后各检测1次. 结果: 治疗后联合组mALB,UAER和mALB/Ucr均低于对照组(P<0.01);治疗后两组FPG和HbAlc水平均比治疗前下降(P<0.01),治疗后联合组HbAlc水平低于对照组(P<0.05);治疗后联合组Cys-C,β₂-MG,NAG,KIM-1水平均比治疗前下降,并低于对照组(P<0.01);经Ridit分析,联合组临床疗效优于对照组(P<0.05). 结论: 糖肾葆颗粒联合依那普利片对早期糖尿病肾病肾功能有较好的保护作用,其疗效优于单纯用依那普利治疗.

Abstract:

Objective: To observe clinical effect and mechanism of Tangshenbao granules combined with enalapril maleate tablets in treating early diabetic nephropathy (DN). Method: Eighty patients with DN were randomly divided into Contrast group (40 cases) and joint group (40 cases) by random number table. Blood glucose of patients in both groups was controlled strictly and blood pressure was controlled by oral 5-10 mg amlodipine tablets once daily. Patients in Contrast group received enalapril maleate tablets, 10 mg/time, 1time/day. Based on the treatment of Contrast group, patients in joint group received 1 dose formula granules of Tangshenbao granules in twice daily. Patients in two groups received a 12-week period of treatment. The ratio of microalbuminuria and creatinine (mALB/Ucr), urine albumin excretion ratio(UAER), fasting blood-glucose (FBG), glycosylated hemoglobin (HbAlc), serous cystatin-c (Cys-C), haematic β₂ microglobulin (β₂-MG), N-acetyl-β-D-glucosaminidase (NAG) and kidney injury molecule-1(KIM-1) were detected before and after treatment. Result: After treatment, UAER and mALB/Ucr in joint group were lower than those in Contrast group (P<0.01). Compared with the time before treatment, levels of FPG and HbAlc in both groups were decreased(P<0.01) and level of HbAlc in joint group was lower than that in Contrast group (P<0.05). Compared with the time before treatment, levels of Cys-C, β2-MG, NAG and KIM-1 in Contrast group were decreased and thay were lower than those in joint group (P<0.01). The curative efficacy in Contrast group was superior to that in joint group according to Ridit analysis (P<0.05). Conclusion: Tangshenbao granules combined with enalapril maleate tablets has a good protection in treating early DN and its curative efficacy is superior to enalapril maleate tablets therapy alone.