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目的:观察五苓胶囊联合骨化三醇对早期糖尿病肾病(DN)患者尿标记性蛋白的影响。方法:64例早期DN患者随机分为对照组及观察组各32例,两组均进行适宜饮食及运动、蛋白质摄入量相对恒定并优化降糖方案,观察组同时加服五苓胶囊(0.9 g,po tid)及骨化三醇胶丸0.25μg,po qd,连续8周。观察两组患者治疗前后空腹血糖(FBG)及餐后2 h血糖(2h BG)、糖化血红蛋白(Hb A1c)、超敏C反应蛋白(hs-CRP)、尿总蛋白、尿白蛋白排泄量(Alb)、尿β2微球蛋白(β2-MG),尿视黄醇结合蛋白(RBP)等变化。结果:两组治疗后FBG、2h BG、Hb A1c、hs-CRP、尿总蛋白、Alb及RBP值均较治疗前明显改善,差异有统计学意义(P<0.05);且观察组治疗后尿总蛋白、Alb、β2-MG、RBP及hs-CRP值明显优于对照组(P<0.05)。结论:五苓胶囊联合骨化三醇可有效减轻早期DN患者肾小球及肾小管的损伤。
Objective: To observe the effect of wuling capsule combined with calcitriol on urinary marker protein in patients with early diabetic nephropathy (DN). Methods: Sixty-four patients with early DN were randomly divided into control group and observation group, with 32 cases in each group. The two groups were given appropriate diet and exercise. The protein intake was relatively constant and the hypoglycemic regimen was optimized. In the observation group, Wuling capsule g, po tid) and calcitriol capsules 0.25μg, po qd, for 8 weeks. The levels of fasting blood glucose (FBG), 2h BG, Hb A1c, hs-CRP, urinary total protein and urinary albumin excretion before and after treatment in both groups were observed. Alb, β2-microglobulin (MGD), urinary retinol binding protein (RBP) and other changes. Results: After treatment, FBG, 2h BG, Hb A1c, hs-CRP, urinary total protein, Alb and RBP in both groups were significantly improved compared with those before treatment (P <0.05) The total protein, Alb, β2-MG, RBP and hs-CRP values were significantly better than the control group (P <0.05). Conclusion: Wuling capsules combined with calcitriol can effectively reduce the early glomerular and renal tubular injury.