中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2014年
7期
60-62
,共3页
糖尿病肾病%雷公藤多苷%尿蛋白定量
糖尿病腎病%雷公籐多苷%尿蛋白定量
당뇨병신병%뢰공등다감%뇨단백정량
Diabetic nephropathy%Tripterygium wilfordii%Urinary protein
目的 观察双倍剂量雷公藤多苷治疗糖尿病肾病大量蛋白尿的临床疗效和安全性.方法 选取临床明确诊断为糖尿病肾病、24h尿蛋白定量≥3.5 g、血浆白蛋白≥25 g/L、血肌酐≤176.8μmol/L的患者60例,随机分为治疗组和对照组,每组30例,治疗组在对照组常规治疗的基础上加用雷公藤多苷,剂量为2 mg/(kg·d),观察两组治疗前及治疗3、6、12个月后24 h尿蛋白定量和血白蛋白(ALB)、血肌酐(Scr)水平.结果 对照组经过积极的血糖、血压控制达标,蛋白尿、血浆白蛋白、血肌酐与治疗前相比,在随访的3、6个月时实验室检查差异无统计学意义(P＞0.05);观察终点蛋白尿减少、血浆白蛋白升高,差异有统计学意义(P＜0.05);血肌酐升高,且与治疗前比较差异有统计学意义(P＜0.05).治疗组蛋白尿在随访3个月时即较治疗前下降,差异有统计学意义(P＜0.05),至6、12个月时差异有统计学意义(P＜0.01);血浆白蛋白于随访6个月时升高明显,差异有统计学意义(P＜0.05);血肌酐在整个观察阶段虽然较治疗前有所升高,但差异无统计学意义(P＞0.05).治疗组3例患者因肝功能异常退出治疗,未见其他不良反应,提示绝大多数患者对于双倍剂量雷公藤多苷耐受性好.结论 双倍剂量雷公藤多苷治疗糖尿病肾病大量蛋白尿安全有效,能够明显减少尿蛋白,延缓肾功能恶化.
目的 觀察雙倍劑量雷公籐多苷治療糖尿病腎病大量蛋白尿的臨床療效和安全性.方法 選取臨床明確診斷為糖尿病腎病、24h尿蛋白定量≥3.5 g、血漿白蛋白≥25 g/L、血肌酐≤176.8μmol/L的患者60例,隨機分為治療組和對照組,每組30例,治療組在對照組常規治療的基礎上加用雷公籐多苷,劑量為2 mg/(kg·d),觀察兩組治療前及治療3、6、12箇月後24 h尿蛋白定量和血白蛋白(ALB)、血肌酐(Scr)水平.結果 對照組經過積極的血糖、血壓控製達標,蛋白尿、血漿白蛋白、血肌酐與治療前相比,在隨訪的3、6箇月時實驗室檢查差異無統計學意義(P＞0.05);觀察終點蛋白尿減少、血漿白蛋白升高,差異有統計學意義(P＜0.05);血肌酐升高,且與治療前比較差異有統計學意義(P＜0.05).治療組蛋白尿在隨訪3箇月時即較治療前下降,差異有統計學意義(P＜0.05),至6、12箇月時差異有統計學意義(P＜0.01);血漿白蛋白于隨訪6箇月時升高明顯,差異有統計學意義(P＜0.05);血肌酐在整箇觀察階段雖然較治療前有所升高,但差異無統計學意義(P＞0.05).治療組3例患者因肝功能異常退齣治療,未見其他不良反應,提示絕大多數患者對于雙倍劑量雷公籐多苷耐受性好.結論 雙倍劑量雷公籐多苷治療糖尿病腎病大量蛋白尿安全有效,能夠明顯減少尿蛋白,延緩腎功能噁化.
목적 관찰쌍배제량뢰공등다감치료당뇨병신병대량단백뇨적림상료효화안전성.방법 선취림상명학진단위당뇨병신병、24h뇨단백정량≥3.5 g、혈장백단백≥25 g/L、혈기항≤176.8μmol/L적환자60례,수궤분위치료조화대조조,매조30례,치료조재대조조상규치료적기출상가용뢰공등다감,제량위2 mg/(kg·d),관찰량조치료전급치료3、6、12개월후24 h뇨단백정량화혈백단백(ALB)、혈기항(Scr)수평.결과 대조조경과적겁적혈당、혈압공제체표,단백뇨、혈장백단백、혈기항여치료전상비,재수방적3、6개월시실험실검사차이무통계학의의(P＞0.05);관찰종점단백뇨감소、혈장백단백승고,차이유통계학의의(P＜0.05);혈기항승고,차여치료전비교차이유통계학의의(P＜0.05).치료조단백뇨재수방3개월시즉교치료전하강,차이유통계학의의(P＜0.05),지6、12개월시차이유통계학의의(P＜0.01);혈장백단백우수방6개월시승고명현,차이유통계학의의(P＜0.05);혈기항재정개관찰계단수연교치료전유소승고,단차이무통계학의의(P＞0.05).치료조3례환자인간공능이상퇴출치료,미견기타불량반응,제시절대다수환자대우쌍배제량뢰공등다감내수성호.결론 쌍배제량뢰공등다감치료당뇨병신병대량단백뇨안전유효,능구명현감소뇨단백,연완신공능악화.
Objective To observe the clinical efficacy and safety of double dose of tripterygium wilfordii (TW) in the treatment of massive proteinuria in diabetic nephropathy patients.Methods Sixty patients were diagnosed as diabetic nephropathy,with a 24-hours urine protein≥3.5 g,serum albumin≥ 25 g/L,serum creatinine ≤ 176.8 μmol / L,which were randomly divided into treatment group and control group,with 30 cases in each group.Patients in control group were given conventional therapy,and patients in treatment group were given TW [2 mg/(kg · d)] based on the conventional therapy.Then the levels of 24-hours urine protein and serum albumin (Alb),serum creatinine (Scr) before treatment and 3 months,6 months,12 months after treatment were observed.Results In the control group,blood glucose,blood pressure was controlled to the normal standards,compared with those before treatment,the levels of proteinuria,serum albumin,serum creatinine after 3 months,6 months followed-up showed no significant difference (P ＞ 0.05),but the urine protein and serum albumin increased at the end,the difference was significant (P ＜ 0.05).Compared with that before treatment,the level of serum creatinine was elevated there was significant difference (P ＜ 0.05).In treatment group,compared with before treatment,proteinuria decreased after 3 months followed-up (P ＜ 0.05),and the difference was statistically significant after 6 months,12 months followed-up (P ＜ 0.01),serum albumin increased significantly after 6 months followed-up,with significant difference (P ＜ 0.05).Throughout the observation phases the level of serum creatinine was increased than that before treatment,but there was no significant difference (P ＞ 0.05).Three patients in the treatment group exited due to abnormal liver function,without adverse reactions,which suggested that the majority of patients seemed to have good tolerance to double dose of TW.Conclusions Double dose of TW is safe and effective for the treatment of diabetic nephropathy proteinuria,and it can significantly reduce urinary protein and retard the deteriorate of renal function.
