目的 探討百令膠囊聯(lián)合利拉魯肽治療早期糖尿病腎病的臨床效果。方法 選取2014年1月—2015年2月佛山市高明區(qū)人民醫(yī)院內(nèi)分泌科收治的早期糖尿病腎病患者160例,隨機(jī)分為對(duì)照組和治療組,每組各80例。對(duì)照組皮下注射利拉魯肽注射液,第1周0.6 mg/d,第2周1.2 mg/d,第3周1.8 mg/d,此后維持1.8 mg/d。治療組在對(duì)照組治療基礎(chǔ)上口服百令膠囊,2粒/次,3次/d。兩組均連續(xù)治療2個(gè)月。觀察兩組的臨床療效,同時(shí)比較兩組治療前后體質(zhì)量指數(shù)(BMI)、總膽固醇(TC)、三酰甘油(TG)、24 h尿白蛋白定量(Upr)、血尿素氮(BUN)、血肌酐(Scr)、空腹血糖(FBG)、糖化血紅蛋白(HbA1c)、膀胱抑素C(CysC)、尿微量白蛋白(mAlb)的變化。結(jié)果 治療后,對(duì)照組和治療組的總有效率分別為80.00%、91.25%,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組BMI、TC、Upr、BUN、Scr、HbA1c、CysC、mAlb較治療前顯著下降,同組治療前后差異均有統(tǒng)計(jì)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(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后兩組TG、FBG均顯著降低,同組治療前后差異均有統(tǒng)計(jì)學(xué)意義(P<0.05),但治療后兩組比較差異無統(tǒng)計(jì)學(xué)意義。對(duì)照組和治療組的不良反應(yīng)發(fā)生率分別為15.00%、3.75%,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 百令膠囊聯(lián)合利拉魯肽治療早期糖尿病腎病具有較好的臨床效果,能改善患者的脂代謝、糖代謝及腎功能相關(guān)指標(biāo),且安全性較高,具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Bailing Capsules combined with liraglutide in treatment of early diabetic nephropathy. Methods Patients (160 cases) with early diabetic nephropathy in Department of Endocrinology of People's Hospital of Gaoming District in Foshan City from January 2014 to January 2015 were randomly divided into control and treatment groups, and each group had 80 cases. The patients in the control group were sc administered with Liraglutide Injection, 0.6 mg/d in the first week, 1.2 mg/d in the second week, 1.8 mg/d in the third week, then the maintain dosage was 1.8 mg/d. The patients in the treatment group were po administered with Bailing Capsules, 2 grains/time, three times daily. The patients in two groups were treated for 2 months. After treatment, the clinical efficacies were evaluated, and the changes of BMI, TC, TG, Upr, BUN, Scr, FBG, HbA1c, CysC, and mAlb in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 80.00% and 91.25%, respectively, and there were differences between two groups (P< 0.05). After treatment, BMI, TC, Upr, BUN, Scr, HbA1c, CysC, and mAlb in two groups were significantly decreased, and the difference was statistically significant in the same group (P< 0.05). After treatment, those observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P< 0.05). TG and FBG in two groups were significantly decreased, and the difference was statistically significant in the same group (P< 0.05). But there was no statistically significant difference between two groups after treatment. The incidence of adverse reactions in control and treatment groups were 15.00% and 3.75%, respectively, and there were differences between two groups (P< 0.05). Conclusion Bailing Capsules combined with liraglutide has clinical curative effect in treatment of early diabetic nephropathy, and can improve the indicators related lipid metabolism, sugar metabolism and renal function with high safety, which has a certain clinical application value.