论文部分内容阅读
目的探讨厄贝沙坦联合六味地黄汤加减对早期糖尿病肾病患者尿微量白蛋白(microalbuminiuria,MAU)的影响。方法选择2011年1月—2013年3月早期糖尿病肾病患者80例,随机分为对照组和观察组各40例。对照组给予赛诺菲(杭州)制药有限公司生产的厄贝沙坦(150 mg/片)1片口服,1次/d。观察组在对照组基础上根据患者的具体情况给予六味地黄汤加减,1剂/d,于早晚饭后分两次温服。1个月为1个疗程,两组均治疗6个疗程,比较治疗1、2、3、4、5、6个月两组MAU、Scr、UAER及不良反应发生情况。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果治疗3、4、5、6个月MAU对照组分别为(45.4±7.9)、(40.3±6.5)、(39.4±9.2)、(36.6±9.1)mg/L,观察组分别为(40.2±7.7)、(35.6±5.7)、(26.4±5.4)、(17.3±7.5)mg/L,两组比较差异均有统计学意义(t=2.981、3.438、7.707、10.351,均P<0.05)。治疗4、5、6个月Scr对照组分别为(79.4±12.8)、(76.5±10.4)、(74.3±11.2)mol/L,观察组分别为(72.3±12.3)、(65.4±10.2)、(60.5±10.1)mol/L,两组比较差异均有统计学意义(t=2.530、4.819、5.787,均P<0.05)。治疗3、4、5、6个月UAER对照组分别为(88.4±14.3)、(79.4±15.4)、(65.6±14.5)、(54.3±13.2)μg/min,观察组分别为(72.4±11.3)、(56.3±12.4)、(47.3±13.4)、(44.3±12.2)μg/min,两组比较差异均有统计学意义(t=5.552、7.389、5.798、3.519,均P<0.05)。治疗期间对照组出现丙氨酸转氨酶升高2例,观察组未出现不良反应。结论在厄贝沙坦治疗早期糖尿病肾病的基础上加用中药六味地黄汤加减,可明显改善患者的MAU、Scr等指标,安全性较高,值得临床推广应用。
Objective To investigate the effect of irbesartan combined with Liuweidihuang decoction on urinary microalbuminuria (MAU) in patients with early diabetic nephropathy. Methods 80 patients with early diabetic nephropathy from January 2011 to March 2013 were randomly divided into control group and observation group of 40 cases. The control group was given irbesartan (150 mg / tablet) produced by Sanofi (Hangzhou) Pharmaceutical Co., Ltd. once a day orally once daily. On the basis of the control group, the observation group was given Liuweidihuang Decoction according to the specific conditions of the patients. One dose / d was given to the observation group twice a day after breakfast and dinner. 1 month for a course of treatment, the two groups were treated for 6 courses, compared 1,2,3,4,5,6 months of treatment MAU, Scr, UAER and adverse reactions. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results The MAU control groups were (45.4 ± 7.9), (40.3 ± 6.5), (39.4 ± 9.2) and (36.6 ± 9.1) mg / L respectively at 3, 4, (T = 2.981,3.438,7.707,10.351, all P <0.05). The difference between the two groups was statistically significant (t = 2.981,3.438,7.707,10.351, P <0.05). The Scr control group were (79.4 ± 12.8), (76.5 ± 10.4) and (74.3 ± 11.2) mol / L on the 4th, 5th and 6th month after treatment, respectively, and were significantly higher in the observation group than those in the observation group (72.3 ± 12.3 vs 65.4 ± 10.2, (60.5 ± 10.1) mol / L, the differences between the two groups were statistically significant (t = 2.530,4.819,5.787, all P <0.05). The UAER of control group were (88.4 ± 14.3), (79.4 ± 15.4), (65.6 ± 14.5) and (54.3 ± 13.2) μg / min respectively in the 3, 4, ), (56.3 ± 12.4), (47.3 ± 13.4) and (44.3 ± 12.2) μg / min respectively. There were significant differences between the two groups (t = 5.552,7.389,5.798,3.519, all P <0.05). In the control group, two cases of alanine aminotransferase increased in the control group, and no adverse reactions occurred in the observation group. Conclusion Irbesartan in the treatment of early diabetic nephropathy based on the addition of traditional Chinese medicine Liuweidihuang Decoction can significantly improve the patient MAU, Scr and other indicators, high safety, worthy of clinical application.