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目的:观察白芍总苷联合慢性肾衰一体化治疗糖尿病肾病(DN)的疗效。方法:将确诊的DN 42例随机分为观察组24例和对照组18例。对照组给予优质低蛋白饮食加α-酮酸,控制血糖、降血压、利尿消肿、降血脂、改善微循环等慢性肾衰一体化治疗;观察组在对照组治疗的基础上口服白芍总苷胶囊0.6g,每天3次。两组疗程均为6个月。分别于治疗前、治疗后1个月、3个月、6个月检测两组24h尿蛋白定量、血浆清蛋白(Alb)、肌酐清除率(Ccr)等指标,以及水肿、胸腔积液、腹水等症状改善情况。结果:观察组治疗3个月、6个月时24h尿蛋白定量显著低于治疗前,且显著低于对照组同时间节点(P<0.05);对照组治疗6个月后,24h尿蛋白定量显著低于治疗前(P<0.05)。血浆Alb及Ccr两组治疗前后及组间不同时间节点比较均差异不显著(P>0.05)。观察组24例中,Ccr>15ml/min的18例患者治疗6个月后,全身水肿明显减轻,胸腹水消失,生活可以自理,肾功能稳定;Ccr<15ml/min的5例患者临床症状体征改善不明显,进入慢性透析状态。结论:白芍总苷联合慢性肾衰一体化治疗可显著改善患者的肌酐清除率,有效缓解Ccr>15ml/min的DN患者的临床症状,改善患者生活质量。
Objective: To observe the efficacy of total glucosides of paeony combined with chronic renal failure in the treatment of diabetic nephropathy (DN). Methods: Forty-two patients with DN were randomly divided into observation group (n = 24) and control group (n = 18). The control group was given high-quality low-protein diet plus α-keto acid, blood glucose control, blood pressure, diuretic swelling, hypolipidemic, and improve microcirculation and other chronic renal failure integrated treatment; observation group in the control group based on oral treatment of total peony root total Glycosides capsule 0.6g, 3 times a day. Two courses of treatment are 6 months. The levels of 24-hour urinary protein, Alb and Ccr were measured before treatment, 1 month, 3 months and 6 months after treatment, and the indexes of edema, pleural effusion, ascites And other symptoms to improve the situation. Results: The urinary protein excretion of observation group at 3 months and 6 months was significantly lower than that before treatment and significantly lower than that of the control group at the same time (P <0.05). After 6 months of treatment, the urinary protein excretion Significantly lower than before treatment (P <0.05). Plasma Alb and Ccr two groups before and after treatment and between groups at different time points were not significantly different (P> 0.05). In the observation group of 24 cases, 18 patients with Ccr> 15ml / min after 6 months of treatment, the edema of the body significantly reduced, the disappearance of pleural effusion, life can take care of themselves, stable renal function; Ccr <15ml / min in 5 patients with clinical signs Improvement is not obvious, into the chronic state of dialysis. Conclusion: The combination of total glucosides of paeony and chronic renal failure can significantly improve the patients’ creatinine clearance, effectively relieve the clinical symptoms of DN patients with Ccr> 15ml / min and improve their quality of life.