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目的:观察通络解毒方联合雷公藤多苷治疗早期糖尿病肾病(DN)的临床疗效。方法:将80例早期DN患者随机分为对照组和观察组各40例。对照组给予降糖、降压及降脂等基础治疗,采用血管紧张素转换酶抑制剂(ACEI)或血管紧张素Ⅱ受体拮抗剂(ARB)控制血压;观察组在对照组用药基础上给予通络解毒方及雷公藤多苷片。疗程均为8周,检测治疗前后尿微量白蛋白排泄率(UAER)、尿微量白蛋白与肌酐的比值(ACR)、血肌酐(SCr)、血尿素氮(BUN)、血浆白蛋白(Alb)、总胆固醇(TC)及甘油三脂(TG)水平变化。结果:总有效率观察组为77.5%,优于对照组的55.0%,差异有显著性意义(P<0.05)。治疗后2组UAER和ACR均比治疗前下降(P<0.05),观察组UAER和ACR水平低于对照组(P<0.05)。治疗后2组SCr、BUN、TG及TC水平较治疗前下降(P<0.05),Alb水平较治疗前上升(P<0.05);治疗后观察组TG及TC水平低于对照组(P<0.05),Alb水平高于对照组(P<0.05)。结论:在ACEI等药物常规治疗的基础上,通络解毒方联合雷公藤多苷能降低蛋白尿,延缓肾功能的损伤,值得临床使用。
Objective: To observe the clinical efficacy of Tongluo Jiedu Decoction combined with tripterygium glycoside in the treatment of early diabetic nephropathy (DN). Methods: Eighty patients with early DN were randomly divided into control group and observation group of 40 cases. The control group was given basic treatment of hypoglycemic, antihypertensive and lipid-lowering, blood pressure was controlled by angiotensin converting enzyme inhibitor (ACEI) or angiotensin Ⅱ receptor antagonist (ARB). The observation group was given on the basis of the control group Tongluo detoxification side and Tripterygium glycosides tablets. The course of treatment was 8 weeks. Urinary microalbuminuria (UAER), urinary albumin to creatinine (ACR), serum creatinine (SCr), blood urea nitrogen (BUN) and serum albumin (Alb) were measured before and after treatment. , Total cholesterol (TC) and triglyceride (TG) levels. Results: The total effective rate in observation group was 77.5%, which was better than that in control group (55.0%), the difference was significant (P <0.05). The levels of UAER and ACR in both groups after treatment were lower than those before treatment (P <0.05). The levels of UAER and ACR in the observation group were lower than those in the control group (P <0.05). After treatment, the levels of SCr, BUN, TG and TC in the two groups were significantly lower than those before treatment (P <0.05), while the levels of Alb in the two groups were higher than those before treatment (P <0.05) ), Alb levels higher than the control group (P <0.05). Conclusion: On the basis of routine treatment of ACEI and other drugs, Tongluo detoxification combined with Tripterygium glycosides can reduce proteinuria and delay the damage of renal function, which deserves to be used clinically.