厄贝沙坦联合活血降糖胶囊治疗早期2型糖尿病肾病Irbesartan combined with Huoxuejiangtang capsule in treating early type-2 diabetic nephropathy
高音;利玲;
摘要(Abstract):
目的探究厄贝沙坦联合活血降糖胶囊治疗早期2型糖尿病肾病(DN)的临床疗效和价值,为早期2型糖尿病肾病的临床治疗提供更为有效的手段和方法。方法将96例临床确诊患有早期2型DN且血压正常的患者随机分为对照组、胶囊组和联合组,每组患者各32例。对照组仅给予常规西医基础治疗,包括降血糖、饮食控制以及体育锻炼等;在对照组治疗基础上,胶囊组再给予活血降糖胶囊进行治疗;而联合组在胶囊组的治疗基础上再给予厄贝沙坦联合治疗。于治疗12周后分别观察3组患者的临床疗效,并比较治疗前后患者空腹血糖(FPG)、尿微量白蛋白排泄率(UAER)、肾功能、血浆脂质、血液流变学以及糖化血红蛋白(HbAlc)的变化情况。结果 3组患者在治疗12周后,联合组患者治疗的总有效率为84.38%,显著高于胶囊组的62.50%和对照组的37.50%(P<0.05,P<0.001),且胶囊组的总有效率亦显著高于对照组(P<0.05);联合组和胶囊组患者的UAER、血液流变学和血浆脂质水平均较治疗前得到显著改善(P<0.05),且联合组患者的改善情况较胶囊组更为显著(P<0.05),而对照组患者治疗前后差异不具有统计学意义(P>0.05);3组患者治疗前后及治疗后各组间FPG、Hb ALc和肾功能无统计学意义(P>0.05)。结论厄贝沙坦联合活血降糖胶囊能有效改善早期2型DN患者的临床症状和血液流变学,显著降低患者血脂和尿微量白蛋白,并能改善和稳定患者肾功能,且作用效果显著优于单纯应用活血降糖胶囊。
关键词(KeyWords): 2型糖尿病肾病;厄贝沙坦;活血降糖胶囊;中西医结合治疗;活血化瘀;滋肾养阴
基金项目(Foundation): 湖北省卫生厅科研基金资助课题(nx201007)
作者(Author): 高音;利玲;
Email:
DOI: 10.13463/j.cnki.jlzyy.2016.05.008
参考文献(References):
- [1]KIRTEE R,IRTAZA U,KANWAR Y S.Renal morphologic lesions reminiscent of diabetic nephropathy.[J].Archives of Pathology&Laboratory Medicine,2013,137(3):351-359.
- [2]王礼文,廖理国,冯学山,等.强化生活方式干预联合厄贝沙坦对早期2型糖尿病肾病的疗效观察[J].中国医师杂志,2015,17(2):285-287.
- [3]GROSS J L,AZEVEDO M J D,SILVEIRO S P,et al.Diabetic nephropathy:diagnosis,prevention and treatment[J].Diabetes Care,2013,19(1):164-176.
- [4]朱志标.糖尿病肾病治疗新进展[J].医学综述,2014,20(21):3938-3940.
- [5]ABUDOUSHALAMU ABUDOUREYIMU,LIU T,MIERBAN ABULIKE,et al.Valsartan capsules,irbesartan tablets in the treatment of patients with diabetic nephropathy,clinical observation of 106 cases[J].Journal of Capital Medical University,2012,33(3):399-402.
- [6]ROS-RUIZ S,ARANDA-LARA P,FERNáNDEZ J C,et al.High doses of irbesartan offer long-term kidney protection in cases of established diabetic nephropathy[J].Nefrologia,2012,32(2):187-196.
- [7]刘伟,潘庆敏.糖尿病肾病临床治疗疗效分析[J].河北医学,2012,18(3):371-373.
- [8]ELEFTHERIADIS T,ANTONIADI,PISSAS G,et al.The renal endothelium in diabetic nephropathy[J].Renal Failure,2013,35(4):592-599.
- [9]叶建华,周晓玲,陈孟华,等.肾脏血流动力学特点在鉴别早期糖尿病肾病中的价值[J].实用医学杂志,2013,29(3):440-442.
- [10]TAVAFI M.Diabetic nephropathy and antioxidants[J].Journal of Nephropathology,2013,2(1):20-27.
- [11]吴雪怡,李航.糖尿病肾病的病理研究及其临床意义[J].中华肾脏病杂志,2012,28(7):564-569.
- [12]陶冬青,胡菊萍,张令晖,等.中西医联合疗法在糖尿病肾病治疗中的临床应用探讨[J].中国中医药咨讯,2012,04(5):306-307.
- [13]HARTNER A,CORDASIC N,KLANKE B,et al.Renal protection by low dose irbesartan in diabetic nephropathy is paralleled by a reduction of inflammation,not of endoplasmic reticulum stress.[J].Biochim Biophys Acta,2014,1842(4):558-565.
- [14]YALCIN O,STüNDAG S,SEN S,et al.The Effects of Enalapril and Irbesartan in Experimental Diabetic Nephropathy[J].Biotechnology&Biotechnological Equipment,2014,21(2):366-371.
- [15]陈茜,孙伟.中医诊治糖尿病肾病伴蛋白尿的研究进展[J].西部中医药,2012,25(3):104-108.
- [16]FULVIA G B,EGIDIO B.Cytosolic Low Molecular Weight Protein-Tyrosine Phosphatase Activity and Clinical Manifestations of Diabetes[J].American Journal of the Medical Sciences,2013,347(2):147-150.
- [17]葛永纯,谢红浪,徐峰,等.糖尿病肾病微量白蛋白尿患者肾脏组织损伤及病情变化的研究[J].肾脏病与透析肾移植杂志,2015,24(3):207-212,269.
- [18]李敏州,高彦彬,马鸣飞,等.糖尿病肾病发病机制研究进展[J].中国实验方剂学杂志,2012,18(22):344-349.
- [19]GEORGESCU A,ALEXANDRU N,ANDREI E,et al.Circulating microparticles and endothelial progenitor cells in atherosclerosis:pharmacological effects of irbesartan[J].Journal of Thrombosis&Haemostasis,2012,10(4):680-691.
- [20]叶学锋,胡泉,涂翔,等.厄贝沙坦治疗糖尿病肾病大鼠蛋白尿作用机制[J].国际泌尿系统杂志,2012,32(2):177-180.
- [21]XINGQING C,ZHAO X,WANG X,et al.Clinical Observation of Irbesartan Combined with Ramipril for Early Diabetic Nephropathy[J].China Pharmacy,2013,24(48):4554-4556.