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目的观察雷公藤多苷联合缬沙坦治疗糖尿病肾病大量蛋白尿的临床疗效。方法将入选的30例患者随机分为A、B两组,两组均在糖尿病饮食管理和运动疗法的基础上,运用胰岛素降糖治疗,将血糖控制在空腹<6.1mmol/l,餐后2小时<8.0mmol/l,并根据具体情况予以降压(血压<130/80mmHg),降脂(血脂控制在CHOL<4.5mmol/l,TG<1.7mmol/l,LDL<2.6mmol/l)及低蛋白饮食(蛋白摄入量以1.0～1.2g/d为宜),在此基础上两组均服用缬沙坦,B组加服雷公藤多苷,治疗8周后观察两组的临床改善情况、尿蛋白情况、血浆白蛋白及肾功能情况。结果两组治疗后24小时尿蛋白、血肌酐均有降低(P<0.05),血浆白蛋白升高(P<0.05),B组尿蛋白减少的幅度明显优于对照组(P<0.05)。结论雷公藤多苷联合缬沙坦治疗糖尿病肾病大量蛋白尿效果明显,可延缓糖尿病肾病发展进程,值得广泛推广。
Objective To observe the clinical efficacy of tripterygium glycosides combined with valsartan in treatment of massive proteinuria in diabetic nephropathy. Methods Thirty patients selected were randomly divided into A and B groups. Both groups were treated with insulin hypoglycemic therapy on the basis of diet management and exercise therapy, and their blood glucose was controlled at 6.1 mmol / l fasting and 2 (Blood pressure <130 / 80mmHg), lipid lowering (lipid control in CHOL <4.5mmol / l, TG <1.7mmol / l, LDL <2.6mmol / l) and Low protein diet (protein intake 1.0-1.2g / d is appropriate), on the basis of both groups were taking valsartan, B plus service tripterygium glycosides, 8 weeks after treatment observed two groups of clinical improvement Situation, urinary protein, plasma albumin and renal function. Results Urinary protein and serum creatinine were decreased (P <0.05) and plasma albumin (P <0.05) 24 hours after treatment in both groups. The decrease of urinary protein in group B was significantly better than that of control group (P <0.05). Conclusion Tripterygium glycosides combined with valsartan treatment of diabetic nephropathy significant effect of large amounts of proteinuria, can delay the development of diabetic nephropathy, it is worth widely disseminated.