尿毒清颗粒治疗早期糖尿病肾病的疗效观察
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摘要
目的:观察尿毒清颗粒治疗早期糖尿病肾病的临床疗效。方法:我院早期糖尿病肾病患者68例,随机分为对照组和治疗组各34例。两组均予ACEI(或ARB)降低尿蛋白,治疗组在ACEI(或ARB)基础上加用尿毒清颗粒。两组患者均治疗3个月。观察两组治疗前后糖化血红蛋白(Hemoglobin A1c,HbA1c)、血尿素氮(Blood urea nitrogen,BUN)、血肌酐(Serum creatinine,Scr)、尿白蛋白排泄率(Urine albumin excretion ratio,UAER)水平,并记录不良反应。结果:两组治疗后尿白蛋白排泄率较治疗前均显著下降,治疗组较对照组下降更明显,差别具有统计学意义(P<0.05)。两组治疗后HbA1c、BUN、Scr较治疗前下降,但差别无统计学意义。所有病例均无严重不良反应发生。结论:早期糖尿病肾病患者在常规西药治疗基础上,加用尿毒清颗粒治疗,可以延缓肾功能恶化,而且安全性好。
Objective:To observe the clinical efficacy of uremic clearance granule(UCG)in the treatment of early diabetic nephropathy(DN).Methods:68patients with early DN of our hospital were randomized into two groups and each group included 34 cases.Both of the groups were given angiotensinⅡreceptor antagonists or angiotensin converting enzyme inhibitor to control urine protein.The treatment group were additionally given UCG on the basis of control group.After a follow-up of three months,the changes of hemoglobin A1c(HbA1c),blood ureanitrogen(BUN),serum creatinine(Scr)and urine albumin excretion ratio(UAER)were compared between two groups before and after treatment;Adverse drug reaction(ADR)were also recorded.Results:Urinary albumin of two groups decreased significantly after treatment,and the treatment group decreased more significantly than the control group(P<0.05).HbA1 c,BUN and Scr of two groups also decreased after treatment.However,there was no statistical significance between two groups.No severe ADR was found in two groups.Conclusion:UCG are effective in the treatment of early DN combine with conventional therapy of western medicine,and can delay deterioration of renal function with sound safety.
Objective:To observe the clinical efficacy of uremic clearance granule(UCG)in the treatment of early diabetic nephropathy(DN).Methods:68patients with early DN of our hospital were randomized into two groups and each group included 34 cases.Both of the groups were given angiotensinⅡreceptor antagonists or angiotensin converting enzyme inhibitor to control urine protein.The treatment group were additionally given UCG on the basis of control group.After a follow-up of three months,the changes of hemoglobin A1c(HbA1c),blood ureanitrogen(BUN),serum creatinine(Scr)and urine albumin excretion ratio(UAER)were compared between two groups before and after treatment;Adverse drug reaction(ADR)were also recorded.Results:Urinary albumin of two groups decreased significantly after treatment,and the treatment group decreased more significantly than the control group(P<0.05).HbA1 c,BUN and Scr of two groups also decreased after treatment.However,there was no statistical significance between two groups.No severe ADR was found in two groups.Conclusion:UCG are effective in the treatment of early DN combine with conventional therapy of western medicine,and can delay deterioration of renal function with sound safety.
引文
[1]Eboh C,Chowdhury TA.Management of diabetic renal disease〔J〕.Ann Transl Med,2015,3(11):154.
[2]Johnson SA,Spurney RF.Twenty years after ACEIs and ARBs:emerging treatment strategies for diabetic nephropathy〔J〕.Am J Physiol Renal Physiol,2015,309(10):F807-820.
[3]郑寅,杨磊,周莹,等.尿毒清颗粒治疗慢性肾功能不全的前瞻性、随机、开放、交叉研究〔J〕.中华肾脏病杂志,2012,28(4):325-326.
[4]Lu ZY,Liu SW,Xie YS,et al.Inhibition of the tubular epithelial-to-mesenchymal transition in vivo and in vitro by the Uremic Clearance Granule〔J〕.Chin J Integr Med,2013,19(12):918-926.
[5]胡勤锦,闫振成.尿毒清联合ARB/ACEI治疗糖尿病肾病大量蛋白尿的疗效观察〔J〕.重庆医学,2014,43(26):3436-3438.
[6]孟宪杰,万毅刚,魏晴雪,等.尿毒清颗粒治疗慢性肾衰竭研究概况〔J〕.中国中药杂志,2013,38(21):3651-3655.
[7]Huang YR,Wei QX,Wan YG,et al.Ureic clearance granule,alleviates renal dysfunction and tubulointerstitial fibrosis by promoting extracellular matrix degradation in renal failure rats,compared with enalapril〔J〕.J Ethnopharmacol,2014,155(3):1541-1552.
[8]Miao XH,Wang CG,Hu BQ,et al.TGF-beta1immunohistochemistry and promoter methylation in chronic renal failure rats treated with Uremic Clearance Granules〔J〕.Folia Histochem Cytobiol,2010,48(2):284-291.
[9]孙冬梅,宁德山,杨友宝,等.尿毒清片质量标准的研究〔J〕.中药新药与临床药理,2002,13(5):302-305.
[10]De Cosmo S,Menzaghi C,Prudente S,et al.Role of insulin resistance in kidney dysfunction:insights into the mechanism and epidemiological evidence〔J〕.Nephrol Dial Transplant,2013,28(1):29-36.
[11]齐桂静.尿毒清对慢性肾衰竭患者胰岛素抵抗的影响〔J〕.中国中西医结合肾病杂志,2010,11(6):537-538.
[2]Johnson SA,Spurney RF.Twenty years after ACEIs and ARBs:emerging treatment strategies for diabetic nephropathy〔J〕.Am J Physiol Renal Physiol,2015,309(10):F807-820.
[3]郑寅,杨磊,周莹,等.尿毒清颗粒治疗慢性肾功能不全的前瞻性、随机、开放、交叉研究〔J〕.中华肾脏病杂志,2012,28(4):325-326.
[4]Lu ZY,Liu SW,Xie YS,et al.Inhibition of the tubular epithelial-to-mesenchymal transition in vivo and in vitro by the Uremic Clearance Granule〔J〕.Chin J Integr Med,2013,19(12):918-926.
[5]胡勤锦,闫振成.尿毒清联合ARB/ACEI治疗糖尿病肾病大量蛋白尿的疗效观察〔J〕.重庆医学,2014,43(26):3436-3438.
[6]孟宪杰,万毅刚,魏晴雪,等.尿毒清颗粒治疗慢性肾衰竭研究概况〔J〕.中国中药杂志,2013,38(21):3651-3655.
[7]Huang YR,Wei QX,Wan YG,et al.Ureic clearance granule,alleviates renal dysfunction and tubulointerstitial fibrosis by promoting extracellular matrix degradation in renal failure rats,compared with enalapril〔J〕.J Ethnopharmacol,2014,155(3):1541-1552.
[8]Miao XH,Wang CG,Hu BQ,et al.TGF-beta1immunohistochemistry and promoter methylation in chronic renal failure rats treated with Uremic Clearance Granules〔J〕.Folia Histochem Cytobiol,2010,48(2):284-291.
[9]孙冬梅,宁德山,杨友宝,等.尿毒清片质量标准的研究〔J〕.中药新药与临床药理,2002,13(5):302-305.
[10]De Cosmo S,Menzaghi C,Prudente S,et al.Role of insulin resistance in kidney dysfunction:insights into the mechanism and epidemiological evidence〔J〕.Nephrol Dial Transplant,2013,28(1):29-36.
[11]齐桂静.尿毒清对慢性肾衰竭患者胰岛素抵抗的影响〔J〕.中国中西医结合肾病杂志,2010,11(6):537-538.