论文部分内容阅读
【目的】探讨雷公藤总苷联合厄贝沙坦治疗早中期糖尿病肾病的疗效。【方法】选取24 h 尿蛋白定量大于1 g 且肾小球滤过率（eGFR）稳定在30 mL／（ min ?1．73 m2）以上的糖尿病肾病患者60例，根据随机数字表将患者随机分入 A 、B 两组，分别给予厄贝沙坦治疗（A 组）和雷公藤总苷＋厄贝沙坦治疗（B 组），疗程6个月，观察其实验室指标变化及中医症状积分（TCM score）变化。【结果】①在治疗6个月时 B 组尿蛋白下降率明显高于 A 组（46．3％ vs 13．4％，P ＜0．05），血浆白蛋白及 eGFR 上升幅度明显高于 A 组，组间比较差异有显著性（ P ＜0．05）。② B 组 C 反应蛋白（CRP）下降幅度明显高于 A 组[（2．44±0．54）mg／mL vs （1．79±0．23 mg ／mL），P ＜0．05）]。③两组在治疗后中医症状积分均较治疗前下降（A 组：19．62±4．12 vs 16．28 ± 2．03；B 组：20．31 ± 3．67 vs 12．39 ± 1．98，均 P ＜0．05），B 组下降较 A 组更显著（ P ＜0．05）。④ B 组治疗6个月后总有效率明显优于 A 组，且组间比较差异有显著性（53．6％ vs 29．2％，P ＜0．05）。【结论】雷公藤总苷联合厄贝沙坦治疗中期糖尿病肾病可改善患者的临床症状，延缓肾损伤。“,”Objective] To evaluate the effects of tripteryguim wilfordli plus irbesartan in patients with early‐to‐middel diabetic nephropathy (DN) .[Methods] A total of 60 DN patients whose proteinuria was more than 1 .0g/24h ,estimated glomerular filtration rate (eGFR) equal or greater than 30 mL /(min ? 1 .73 m2 ) were enrolled .They were divided into two groups of A ( n = 30 ,irbesartan 75 ~ 300 mg/d for 6 months) and B ( n = 30 ,tripteryguim wilfordli plus irbesartan for 6 months) .At the end‐point ,objective indictors (de‐crease of proteinuria ,increase of serum creatinine (SCr) and C‐reactive protein) and traditional Chinese medi‐cine (TCM ) score were evaluated .[Results] (1) At the treatment end‐point ,the decrease percentage of pro‐teinuria in group B was higher than that of in group A (46 .3% vs 13 .4% ,P < 0 .05) ,the increase percentage of plasma albumin and eGFR in group B were higher than those of in group A ( P < 0 .05) ;(2) The decreasing range of CRP was higher in group B than that of in group A [(2 .44 ± 0 .54)vs (1 .79 ± 0 .23) mg/mL ,P <0 .05] ;(3) TCM score significantly improved in both groups after 6‐month treatment (group A :19 .62 ± 4 .12 vs 16 .28 ± 2 .03 ;group B :20 .31 ± 3 .67 vs 12 .39 ± 1 .98 ,P < 0 .05) ;(4) After 6‐month treatment ,the over‐all effective rates in group B was better than that in group A (53 .6% vs 29 .2% ,P < 0 .05) .[Conclusion] The combination of tripteryguim wilfordli and irbesartan can improve clinical symptomS and renal functionS in pa‐tients with early‐to‐middle DN .