CAJ | 학술논문

目的探讨肾炎康复片联合缬沙坦治疗肾功能正常Ⅳ期糖尿病肾病患者蛋白尿的临床疗效.方法将厦门市第二医院2009年-2012年就诊的120例肾功能正常Ⅳ期糖尿病肾病患者,随机数字表法分为单纯缬沙坦组、肾炎康复片联合缬沙坦组,两组患者各60例,均常规予以限制饮食,控制血糖、血压,调节血脂等基础治疗;此外,单纯缬沙坦组予以缬沙坦160 mg/次、每天1次,肾炎康复片联合缬沙坦组予以肾炎康复片5片/次、每天3次,联合缬沙坦160 mg/次、每天1次,治疗16周后,检测两组患者的24 h尿白蛋白定量、血肌酐、血糖、血脂等水平.结果治疗16周后肾炎康复片联合缬沙坦组临床疗效总有效率66.7％,高于单纯缬沙坦组(46.7％),差异有统计学意义(P＜0.05).治疗后两组患者24h尿白蛋白定量均较治疗前明显下降,肾炎康复片联合缬沙坦组尿白蛋白定量明显低于单纯缬沙坦组,差异有统计学意义[(1.77 ±0.79) g vs.(2.29±1.36)g,t=2.617,P＜0.05].两组患者血肌酐、血糖等指标与治疗前相比差异无统计学意义(P均＞0.05).结论肾炎康复片联合缬沙坦治疗比单用缬沙坦更能有效降低肾功能正常Ⅳ期糖尿病肾病患者的蛋白尿.
목적 탐토신염강복편연합힐사탄치료신공능정상Ⅳ기당뇨병신병환자단백뇨적림상료효.방법 장하문시제이의원2009년-2012년취진적120례신공능정상Ⅳ기당뇨병신병환자,수궤수자표법분위단순힐사탄조、신염강복편연합힐사탄조,량조환자각60례,균상규여이한제음식,공제혈당、혈압,조절혈지등기출치료;차외,단순힐사탄조여이힐사탄160 mg/차、매천1차,신염강복편연합힐사탄조여이신염강복편5편/차、매천3차,연합힐사탄160 mg/차、매천1차,치료16주후,검측량조환자적24 h뇨백단백정량、혈기항、혈당、혈지등수평.결과 치료16주후신염강복편연합힐사탄조림상료효총유효솔66.7％,고우단순힐사탄조(46.7％),차이유통계학의의(P＜0.05).치료후량조환자24h뇨백단백정량균교치료전명현하강,신염강복편연합힐사탄조뇨백단백정량명현저우단순힐사탄조,차이유통계학의의[(1.77 ±0.79) g vs.(2.29±1.36)g,t=2.617,P＜0.05].량조환자혈기항、혈당등지표여치료전상비차이무통계학의의(P균＞0.05).결론 신염강복편연합힐사탄치료비단용힐사탄경능유효강저신공능정상Ⅳ기당뇨병신병환자적단백뇨.
Objective To investigate the therapeutic effects of Shenyankangfu tablet combined with valsartan capsule on proteinuria in patients with stage Ⅳ diabetic nephropathy and normal renal function.Methods 120 patients with stage Ⅳ diabetic nephropathy and normal renal function were randomly divided into two groups:valsartan group(n =60,valsartan 160 mg qd) and valsartan combined with Shenyankangfu tablets group (n =60,Shenyankangfu tablet 5 tablets tid combined with Valsartan 160 mg qd),and were treated for 16 weeks.Both groups were treated with the same basic diet control and routine treatment.After 16-week course of treatment,24 hours urinary protein,serum creatinine,blood glucose and blood lipids were determined and compared.Results Mter 16-week treatment,the total efficiency of the experiment group and the control group was 66.7％ and 46.7％ respectively,there was a significant difference between the two groups (P ＜ 0.05).The 24 hours urinary protein of both groups after treatment were significantly decreased,but in valsartan combined with Shenyankangfu tablets group,the 24 hours urinary protein decreased greatly [(1.77 ± 0.79) g vs.(2.29 ± 1.36) g,t =2.617,P ＜ 0.05].The levels of serum creatinine and blood glucose of both groups had no significant differences before and after treatment(P ＞ 0.05).Conclusion Shenyankangfu tablet combined with Valsartan capsule can decrease the urinary protein in patients with stage Ⅳ diabetic nephropathy,the therapeutic effect is better than valsartan alone.