目的 探討雷公藤多苷聯(lián)合替米沙坦治療糖尿病腎病的臨床療效。方法 選取2012年10月—2014年10月天津市第一中心醫(yī)院內(nèi)分泌科收治的2型糖尿病腎病患者126例,隨機(jī)分為對照組(64例)和治療組(62例)。對照組在基礎(chǔ)治療上口服替米沙坦片80 mg/次,1次/d。治療組在對照組治療基礎(chǔ)上口服雷公藤多苷片,20 mg/次,3次/d。兩組均連續(xù)治療12周。觀察兩組的臨床療效,同時比較兩組治療前后血肌酐(Scr)、血尿素氮(BUN)、24 h尿蛋白定量、腎小球濾過率(GFR)、糖化血紅蛋白(HbA1c)的水平變化。結(jié)果 治療后,對照組和治療組的總有效率分別為85.94%、96.77%,兩組比較差異具有統(tǒng)計學(xué)意義(P <0.05)。治療后,兩組患者24 h尿蛋白定量、Scr、BUN、HbA1c水平出現(xiàn)明顯降低,GFR較治療前升高,同組治療前后比較差異具有統(tǒng)計學(xué)意義(P <0.05);且治療組這些觀察指標(biāo)的改善程度優(yōu)于對照組,兩組比較差異有統(tǒng)計學(xué)意義(P <0.05)。結(jié)論 雷公藤多苷聯(lián)合替米沙坦治療糖尿病腎病具有較好的臨床療效,可有效降低患者尿蛋白水平,無不良反應(yīng),具有一定的臨床推廣應(yīng)用價值。

Objective To observe the effect of tripterygium glycosides combined with telmisartan in treatment of diabetic nephropathy. Methods Patients (126 cases) with diabetic nephropathy in Department of Endocrinology of Tianjin First Central Hospital from October 2012 to October 2014 were randomly divided into control (64 cases) and treatment groups (62 cases). The patients in the control group were po administered with Telmisartan Tablets on the basis of foundation treatment, 80 mg/time, once daily. The patients in the treatment group were po administered with Tripterygium Glycosides Tablets, 20 mg/time, three times daily. Two groups were treated for 12 weeks. After treatment, the efficacy was evaluated, and the changes of Scr, BUN, 24 h urine protein quantitative, GFR, and HbA1c in two groups before and after treatment were compared. Results After treatment, the efficacies in the control and treatment groups were 85.94% and 96.77%, respectively, and there was difference between two groups (P < 0.05). After treatment, Scr, BUN, 24 h urine protein quantitative, and HbA1c in two groups were significantly reduced. While GFR was significantly increased, and the difference was statistically significant in the same group (P < 0.05). And these indicators in treatment group improved better than those in the control group, with significant differences between two groups (P < 0.05). Conclusions Tripterygium glycosides combined with telmisartan has good clinical efficacy in treatment of diabetic nephropathy, and can effectively reduce the urinary protein level, which has certain clinical application value.

天津市衛(wèi)計委科技基金資助項目(2013kz025)