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中国临床研究英文版:2018,31(12):1624-1627
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降糖精治疗早期糖尿病肾病患者的疗效及其对尿微量白蛋白的影响
(南通市中医院肾脏内分泌科,江苏 南通 226001)
Effect of Jiangtangjing granule on early diabetic nephropathy and its influence on urinary microalbumin
(Department of Renal Endocrinology, Nantong Hospital of Traditional Chinese Medicine, Nantong, Jiangsu 226001, China)
摘要
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Received:July 10, 2018   Published Online:December 20, 2018
中文摘要: 目的 探讨降糖精对早期糖尿病肾病(DN)患者疗效及尿微量白蛋白(UMA)的影响。 方法 连续选择2016年8月至2017年9月明确诊断DN的患者42例,随机分为对照组与观察组,每组各21例。对照组予以降糖、降压等常规西医治疗,观察组在对照组治疗基础上联合南通市中医院自制制剂降糖精(批准文号:苏药制字Z04001366,含黄芪、制黄精、薏苡仁、葛根、山药、生山楂、水蛭、白芥子等) 治疗,每日3次,每次10 g,温水冲服。两组疗程均为8周。分别观察两组患者治疗前后UMA、尿β2微球蛋白(β2-MG)、血尿素氮(BUN)及血肌酐(SCr)等指标变化情况。并结合患者临床症状及体征改善情况评价不同方案间疗效的差异。此外,分别观察两组患者药物相关不良反应发生情况以评价其安全性。 结果 观察组患者治疗总有效率为85.71%,较对照组(66.67%)略有升高,但差异无统计学意义(P>0.05)。治疗前两组患者中医症候积分无统计学差异(P>0.05),治疗后2、4、8周,两组患者中医症候积分比治疗前明显下降,且观察组低于对照组(P<0.05)。治疗前两组患者残余肾功能(RRF)和尿量无统计学差异(P>0.05);治疗后,两组患者RRF和尿量均比治疗前明显下降(P<0.01),且对照组低于观察组(P<0.05,P<0.01)。治疗后,两组患者的UMA、β2-MG、BUN水平较治疗前均有显著下降,且观察组患者UMA及β2-MG水平较对照组显著降低,差异有统计学意义(P<0.05)。两组患者药物相关不良反应发生率间未见统计学差异(P>0.05)。两组患者治疗过程中均未见明显药物相关不良反应发生。 结论 降糖精颗粒可显著提高早期DN患者的临床疗效,并能降低患者UMA、β2-MG及BUN水平,且用药过程安全性良好。
Abstract:Objective To investigate the influences of Jiangtangjing granule on the curative effect of early diabetic nephropathy (DN) and on urinary microalbumin (UMA). Methods Forty-two patients with confirmed DN from August 2016 to September 2017 were selected and randomly divided into control group and observation group (n=21, each). The routine western medicine such as hypoglycemia and hypotension was given in control group, and the Jiangtangjing granule[self-made preparations of Nantong Hospital of Traditional Chinese Medicine, approval number:Z04001366, containing Huangqi (Astragalus propinquus), Huangjing (Polygonatumsibiricum), Yiyi (Coixlacryma-jobi seed), Gegen (Pueraria lobata root), Shanyao (Dioscoreapolystachya), Shanzha (Crataeguscuneata), Shuizhi (Hirudomedicinalis) and Baijiezi (Sinapis alba seed)] was added in observation group based on the routine treatment. All patients took medicine 3 times a day, 10 g each time with warm water for 8 weeks in both two groups. The change in the levels of UMA, urinary beta-2-microglobulin (β2-MG), blood urea nitrogen (BUN) and serum creatinine (SCr) were observed before and after treatment; the difference of curative effect was evaluated based on the improvement of clinical symptoms and signs; the incidence of adverse drug reactions (ADR) was observed to evaluate their safety in two groups. Results The total effective rate was 85. 71% in observation group and 66. 67% in control group, but there was no statistical difference (P>0.05). Before treatment, there was no significant difference in Traditional Chinese Medicine (TCM) syndrome scores between two groups (P>0.05). After 2-, 4-and 8-week of treatment, TCM symptom scores decreased significantly compared with those before treatment in both two groups, and they were significantly lower in observation group than those in control group ( all P<0.05). Before treatment, there were no significant differences in residual renal function (RRF) and urine volume between two groups (P>0.05). After treatment, RRF and urine volume were significantly lower than those before treatment in two groups and decreased significantly in observation group compared with control group (P<0.05) ; UMA, β2-MG, BUN and other indicators were significantly lower than those before treatment in both two groups, and UMA and β2-MG in observation group were significantly lower than those in control group (all P<0.05). No obvious adverse drug reactions occurred during the treatment in both two groups without statistical difference in the incidence of drug related adverse reactions between two groups (P>0.05). Conclusion Jiangtangjing granule can significantly improve the clinical efficacy of early DN patients and reduce the levels of UMA, β2-MG and BUN. The safety of medication-use process is good.
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