尿毒清颗粒联合厄贝沙坦治疗早期糖尿病肾病的效果观察

李强 曹敏 李凯 励捷

【摘要】 目的：探討尿毒清颗粒联合厄贝沙坦治疗早期糖尿病肾病（DN）的临床效果及用药安全性。方法：选取2017年1月-2018年12月中国中医科学院广安门医院南区肾病科收治的80例早期DN患者为研究对象。将患者随机分为观察组和对照组，每组40例。对照组在常规治疗基础上加用厄贝沙坦，观察组在对照组基础上联用尿毒清颗粒，两组均连续用药治疗3个月。观察两组临床疗效及不良反应发生情况，比较两组治疗前后肾功能、炎症因子、氧化应激指标的变化。结果：治疗3个月后，观察组治疗总有效率为95.00%，明显高于对照组的80.00%，差异有统计学意义（P<0.05）。治疗前，两组U-mAlb、BUN、Scr、Ccr、hs-CRP、IL-18、TNF-α、MDA、AOPP、SOD水平比较，差异均无统计学意义（P>0.05）。治疗3个月后，两组U-mAlb、BUN、Scr、hs-CRP、IL-18、TNF-α、MDA、AOPP水平均低于治疗前，且观察组上述指标均低于对照组，差异均有统计学意义（P<0.05）。治疗3个月后，两组Ccr、SOD水平均高于治疗前，且观察组上述指标均高于对照组，差异均有统计学意义（P<0.05）。观察组的不良反应发生率为15.00%，与对照组的17.50%比较，差异无统计学意义（P>0.05）。结论：尿毒清颗粒联合厄贝沙坦治疗早期糖尿病肾病效果显著，可明显改善患者肾功能、降低炎症因子水平、改善氧化应激指标，且安全性高，值得临床推广应用。

【关键词】 尿毒清颗粒 厄贝沙坦 早期糖尿病肾病 炎症因子 氧化应激指标

Observation on the Effect of Niaoduqing Granules Combined with Irbesartan in the Treatment of Early Diabetic Nephropathy/LI Qiang， CAO Min， LI Kai， LI Jie. //Medical Innovation of China， 2021， 18（16）： 0-020

[Abstract] Objective： To investigate the clinical effect and safety of Niaoduqing Granules combined with Irbesartan in the treatment of early diabetic nephropathy （DN）. Method： A total of 80 patients with early DN who were admitted to the nephrology department of Guang anmen Hospital， China Academy of Chinese Medical Sciences from January 2017 to December 2018 were selected as the research objects. The patients were randomly divided into observation group and control group， 40 cases in each group. The control group was treated with Irbesartan on the basis of conventional treatment， and the observation group was treated with Niaoduqing Granules on the basis of the control group， the two groups were treated with drugs continuously for 3 months. Clinical efficacy and the incidence of adverse reactions in the two groups were observed. The changes of renal function， inflammatory factors and oxidative stress indexes were compared between the two groups before and after treatment. Result： After 3 months of treatment， the total effective rate of the observation group was 95.00%， which was significantly higher than 80.00% of the control group， the difference was statistically significant （P<0.05）. Before treatment， there were no significant differences in the levels of U-mAlb， BUN， Scr， Ccr， hs-CRP， IL-18， TNF-α， MDA， AOPP and SOD between the two groups （P>0.05）. After 3 months of treatment， the levels of U-mAlb， BUN， Scr， hs-CRP， IL-18， TNF-α， MDA and AOPP in both groups were lower than those in before treatment， and the above indexes in the observation group were lower than those in the control group， the differences were statistically significant （P<0.05）. After 3 months of treatment， the levels of Ccr and SOD in both groups were higher than before， and the above indexes in the observation group were higher than those in the control group， the differences were statistically significant （P<0.05）. The incidence of ADR in the observation group was 15.00%， compared with 17.50% in the control group， there was no statistical significance （P>0.05）. Conclusion： Niaoduqing Granules combined with Irbesartan has a significant effect on the treatment of early diabetic nephropathy， which can significantly improve the renal function of patients， reduce the level of inflammatory factors， and improve oxidative stress indicators， with high safety and worthy of clinical promotion and application.

[Key words] Niaoduqing Granules Irbesartan Early diabetic nephropathy Inflammatory factors Oxidative stress index

First-authors address： South District of Guanganmen Hospital， China Academy of Chinese Medical Sciences， Beijing 102600， China

doi：10.3969/j.issn.1674-4985.2021.16.004

糖尿病腎病（diabetic nephropathy， DN）是糖尿病患者最常见、治疗最棘手、致死率极高的微血管并发症。近年来，随着国内糖尿病发病率逐年上升，糖尿病肾病发生率也在迅速攀升。DN呈渐进性、不可逆地发展成为慢性肾功能衰竭（CRF）。美国一项调查研究表明，病程超过25年的糖尿病患者25%～40%发生DN，约40%DN患者进展到终末期肾病[1]。在我国维持性血液透析患者中，DN所占比例高达30%，仅次于慢性肾小球肾炎[2-3]。早期诊断、早期治疗，可延缓DN病情进展，改善患者预后。……