目的 研究舒洛地特聯(lián)合瑞格列奈治療糖尿病腎病的臨床療效。方法 選取2014年5月-2015年2月重慶市南岸區(qū)人民醫(yī)院收治的糖尿病腎病患者200例,隨機分為對照組和治療組,每組各100例。對照組口服瑞格列奈片,0.5 mg/次,2次/d,連續(xù)使用2周后根據(jù)患者表現(xiàn)出來的具體癥狀調(diào)整用藥劑量。治療組在對照組治療基礎(chǔ)上口服舒洛地特軟膠囊,1粒/次,2次/d。兩組均連續(xù)治療4個月。觀察兩組的臨床療效,同時比較治療前后兩組患者空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血紅蛋白(HbA1c)、體質(zhì)量指數(shù)(BMI)、24 h尿蛋白、血肌酐(Scr)、尿素氮(BUN)、IL-6、IL-10、TNF-α的變化情況。結(jié)果 治療后,對照組和治療組的總有效率分別為88.0%、96.0%,兩組比較差異有統(tǒng)計學(xué)意義(P<0.05)。治療后,兩組患者FPG、2 h PBG、HbA1c、24 h尿蛋白、Scr、BUN、IL-6、IL-10、TNF-α均顯著降低,同組治療前后差異有統(tǒng)計學(xué)意義(P<0.05);治療后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);治療后治療組患者BMI較治療前顯著降低,對照組無明顯變化,兩組比較差異有統(tǒng)計學(xué)意義(P<0.05)。結(jié)論 舒洛地特聯(lián)合瑞格列奈治療糖尿病腎病具有較好的臨床療效,可較好的控制患者的血糖水平,減輕腎臟損害,具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical effect of sulodexide combined with repaglinide in treatment of diabetic nephropathy.Methods Patients (200 cases) with diabetic nephropathy in People's Hospital in Nan'an Distract of Chongqing City from May 2014 to February 2015 were randomly divided into control and treatment groups, and each group had 100 cases. The patients in the control group were poadministered with Repaglinide Tablets, 0.5 mg/time, twice daily, and the dosage adjusted according to specific symptoms of patients after 2 weeks. The patients in the treatment group were poadministered with Sulodexide Soft Capsules on the basis of the control group, 1 grain/time, twice daily. The patients in two groups were treated for 4 months. After treatment, the efficacy was evaluated, and the changes of FPG, 2 h PBG, HbA1c, BMI, 24 h urine protein, Scr, BUN, IL-6, IL-10, and TNF-α in two groups before and after treatment were compared.Results After treatment, the efficacies in the control and treatment groups were 88.0% and 96.0%, respectively, and there were differences between two groups (P < 0.05). After treatment, FPG, 2 h PG, HbA1c, 24 h urine protein, Scr, BUN, IL-6, IL-10, and TNF-α in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, BMI in treatment group was significantly decreased, and there was no significant change in the control group, with significant difference between two groups (P < 0.05).Conclusions Sulodexide combined with repaglinide has clinical curative effect in treatment of diabetic nephropathy, and can better control the blood sugar levels, and also can relieve kidney damage, which has a certain clinical application value.