二甲双胍联合血栓通治疗对糖尿病肾病患者肾功能及血液流变学的影响  

Effects of Metformin Combined with Xueshuantong on Renal Function and Hemorheology in Patients with Diabetic Nephropathy

作　　者：应喜慧 刘伟 李娟[1] YING Xi-hui;LIU Wei;LI Juan(Department of Endocrinology,Hospital of Traditional Chinese Medicine in Xindu District,Chengdu 610500,China;Department of General Medicine,Hospital of Traditional Chinese Medicine in Xindu District,Chengdu 610500,China)

机构地区：[1]成都市新都区中医医院内分泌科,成都610500 [2]成都市新都区中医医院综合内科,成都610500

出　　处：《临床误诊误治》2020年第10期40-44,共5页Clinical Misdiagnosis & Mistherapy

基　　金：四川省卫计委计划项目(17PJ513)。

摘　　要：目的探讨二甲双胍联合血栓通治疗对糖尿病肾病(diabetic nephropathy,DN)患者肾功能及血液流变学的影响。方法选取本院2014年2月-2019年6月收治的100例DN患者,据用药方法的不同分为两组,对照组48例在生活方式干预基础上予二甲双胍治疗,观察组52例在对照组基础上联合血栓通治疗。治疗3个月后比较两组疗效,治疗前后血糖、肾功能、血液流变学、炎性指标差异及不良反应发生情况。结果观察组治疗总有效率为94.23%高于对照组的81.25%(χ^2=3.987,P=0.046)。两组治疗后空腹血糖、糖化血红蛋白、胰岛素抵抗指数、尿素、肌酐、尿微量白蛋白排泄率、全血低切黏度、全血高切黏度、纤维蛋白原、血浆黏度及白细胞介素-6、肿瘤坏死因子-α、单核细胞趋化蛋白-1水平较治疗前降低,且观察组上述指标亦低于对照组,差异有统计学意义(P<0.01)。治疗期间两组均未发现严重不良反应。结论二甲双胍联合血栓通治疗DN效果显著,可有效控制DN患者血糖,改善肾功能及血液流变学指标,降低血液黏度及炎性因子水平,且安全性高。Objective To explore the effects of Metformin combined with Xueshuantong on renal function and hemorheology in patients with diabetic nephropathy(DN).Methods A total of 100 DN patients admitted to our hospital from February 2014 to June 2019 were enrolled.They were divided into two groups according to different medication methods.The 48 patients in control group were treated with Metformin on the basis of lifestyle intervention,while 52 patients in observation group were supplemented with Xueshuantong on the basis of control group.The curative effect after 3 months of treatment,differences in blood glucose,renal function,hemorheology and inflammatory indexes before and after treatment,and occurrence of adverse reactions were compared between the two groups.Results The total response rate of treatment in observation group was higher than that in control group(94.23%vs 81.25%)(χ^2=3.987,P=0.046).After treatment,fasting blood glucose,glycosylated hemoglobin,insulin resistance index,blood urea nitrogen(BUN),serum creatinine(Scr),urinary albumin excretion rate(UAER),whole blood low-shear viscosity,whole blood high-shear viscosity,fibrinogen,plasma viscosity,interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and monocyte chemoattractant protein-1(MCP-1)in both groups were decreased,which were lower in observation group than control group(P<0.01).There were no severe adverse reactions during treatment in either group.Conclusion Metformin combined with Xueshutong is effective in the treatment of DN,which can effectively control blood glucose level,improve renal function and hemorheology indexes,and reduce blood viscosity and levels of inflammatory factors with high safety.

关 键 词：糖尿病肾病 二甲双胍 血栓通 血糖 白细胞介素 

分 类 号：R587.24[医药卫生—内分泌]