目的 觀察六味地黃丸聯(lián)合氯沙坦鉀治療早期糖尿病腎病的臨床療效。方法 選擇2010年12月—2014年8月灤平縣中醫(yī)院收治的早期糖尿病腎病患者100例, 隨機分為治療組與對照組, 每組50例。對照組口服氯沙坦鉀片50 mg/次, 1次/d。治療組患者在對照組的基礎上口服六味地黃丸, 9 g/次, 2次/d。兩組均連續(xù)治療8周。觀察兩組患者的臨床療效, 同時比較兩組患者收縮壓、舒張壓、平均動脈壓、血肌酐(Scr)、血尿素氮(BUN)、尿微量蛋白、尿白蛋白排泄率(UAER)、C反應蛋白(CRP)的變化。結(jié)果 治療后, 對照組和治療組的總有效率分別為70.0%、92.0%, 兩組總有效率比較差異有統(tǒng)計學意義(P<0.05)。治療后, 兩組患者收縮壓、舒張壓、平均動脈壓、Scr、BUN、尿微量蛋白、UAER、CRP均較治療前顯著降低, 同組治療前后差異有統(tǒng)計學意義(P<0.05);且治療后治療組這些觀察指標(除Scr、BUN外)的改善程度優(yōu)于對照組, 兩組比較差異有統(tǒng)計學意義(P<0.05)。結(jié)論 六味地黃丸聯(lián)合氯沙坦鉀治療早期糖尿病腎病具有較好的臨床療效, 可改善腎功能, 有效降低尿微量蛋白, 具有一定的臨床推廣價值。

Objective To investigate the effect of Liuwei Dihuang Pills combined with losartan potassium in treatment of early diabetic nephropathy. Methods Patients (100 cases) with early diabetic nephropathy in Luanping County Hospital of Traditional Chinese Medicine from December 2010 to August 2014 were randomly divided into control and treatment groups, and each group had 50 cases. The patients in the control group were po administered with Losartan Potassium Tablets, 50 mg/time, once daily. The patients in the treatment group were po administered with Liuwei Dihuang Pills on the basis of control group, 9 g/time, twice daily. Two groups were treated for eight weeks. After treatment, the efficacy was evaluated, and the changes of systolic pressure, diastolic blood pressure, mean arterial pressure, Scr, BUN, urine micro protein, UAER, and CRP in two groups were compared. Results The efficacies in control and treatment groups were 70.0% and 92.0%, respectively, and there were differences between two groups (P < 0.05). After treatment, systolic pressure, diastolic blood pressure, mean arterial pressure, Scr, BUN, urine micro protein, UAER, and CRP in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And these indicators (except Scr and BUN) in treatment group improved better than those in the control group, with significant differences between two groups (P < 0.05). Conclusion Liuwei Dihuang Pills combined with losartan potassium has good clinical efficacy in treatment of early diabetic nephropathy, and can improve renal function, also can effectively reduce the urine micro protein, which has a certain clinical value.