津力达颗粒联合通心络胶囊治疗2型糖尿病肾病的临床研究  

Clinical study of Jinlida granule combined with Tongxinluo capsule on type 2 diabetic nephropathy

作　　者：刘红利 田金悦[1] 位庚[1] 孟令华[1] LIU Hongli;TIAN Jinyue;WEI Geng;MENG Linghua(The Second Hospital of Shijiazhuang City,Shijiazhuang 050035,Hebei,China)

机构地区：[1]河北省石家庄市第二医院

出　　处：《现代中西医结合杂志》2019年第28期3096-3100,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省中医药管理局资助项目(2018257)

摘　　要：目的观察津力达颗粒联合通心络胶囊治疗2型糖尿病肾病的临床疗效,探讨其作用机制。方法将120例2型糖尿病肾病Ⅲ期患者随机分为对照组和治疗组各60例,对照组予常规降糖、降压、降脂等治疗,治疗组在对照组治疗基础上予津力达颗粒(1袋/次,3次/d)、通心络胶囊(4粒/次,3次/d)口服,2组观察疗程均为12周。观察2组患者治疗前后糖代谢指标[空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋(HbA1c)、胰岛素抵抗指数(HOMA-IR)]、脂代谢指标[三酰甘油(TG)、胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、肾功能指标[血肌酐(SCr)、尿微量白蛋白排泄率(UAER)、尿β2微球蛋白(Uβ2-MG)]、血管内皮细胞生长因子(VEGF)、尿足细胞标志蛋白(PCX)水平变化情况,统计2组治疗12周后的临床疗效及不良反应发生情况。结果2组治疗后FPG、2hPG、HbA1c、HOMA-IR均较治疗前明显降低(P均<0.05);2组治疗后FPG、2hPG、HbA1c比较差异均无统计学意义(P均>0.05),但治疗组HOMA-IR明显低于对照组(P<0.05)。2组治疗后TG、TC、LDL-C、SCr、UAER、Uβ2-MG、VEGF、PCX水平均明显低于治疗前(P均<0.05),HDL-C水平均明显高于治疗前(P均<0.05);治疗后治疗组TG、TC、LDL-C、SCr、UAER、Uβ2-MG、VEGF、PCX水平均明显低于对照组(P均<0.05),HDL-C水平明显高于对照组(P<0.05)。对照组、治疗组临床总有效率分别为61.7%(37/60)和80.0%(48/60),治疗组明显高于对照组(P<0.05)。结论津力达颗粒联合通心络胶囊治疗2型糖尿病肾病Ⅲ期患者疗效优于常规西医治疗,机制可能与改善胰岛素抵抗,调节脂代谢,改善肾脏微循环环境,保护足细胞有关。Objective It is to observe the clinical efficacy of Jinlida granule combined with Tongxinluo capsule in the treatment of type 2 diabetic nephropathy and to explore its mechanism.Methods 120 patients with type 2 diabetic nephropathy at stageⅢwere randomly divided into control group and treatment group,60 cases in each group.The control group was treated with conventional hypoglycemic,antihypertensive and lipid-lowering medicine.The treatment group was given Jinlida granule(1 bag/time,3 times/d)and Tongxinluo capsules(4 capsules/time,3 times/d)orally on the basis of the control group.The two groups were treated for 12 weeks.The changes of glucose metabolism indicators[fasting plasma glucose(FPG),postprandial 2 h blood glucose(2hPG),haemoglobin A1c(HbA1c),insulin resistance index(HOMA-IR)],lipid metabolism index[triacylglycerol(TG),cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)],renal function index[serum creatinine(SCr),urinary albumin excretion rate(UAER),urineβ2 microglobulin(Uβ2-MG)],vascular endothelial growth factor(VEGF),podocalyxin(PCX)before and after treatment were observed in the two groups,the clinical efficacy and adverse reactions of the two groups after 12 weeks of treatment were assessed or recorded.Results FPG,2 hPG,HbA1c and HOMA-IR after treatment were significantly lower than those before treatment in the two groups(P<0.05).There was no significant difference in FPG,2hPG and HbA1c between the two groups after treatment(P>0.05),but the HOMA-IR in the treatment group was significantly lower than that in the control group(P<0.05).The levels of TG,TC,LDL-C,SCr,UAER,Uβ2-MG,VEGF and PCX were significantly lower(P<0.05),and the HDL-C level was significantly higher after treatment than those before treatment in the two groups(P<0.05);the levels of TG,TC,LDL-C,SCr,UAER,Uβ2-MG,VEGF and PCX in the treatment group were significantly lower and the level of HDL-C was significantly higher after treatment than that in the control group(P<0.05).The tot

关 键 词：脉络学说 津力达颗粒 通心络胶囊 血管内皮细胞生长因子 尿足细胞标志蛋白 

分 类 号：R587.2[医药卫生—内分泌]