苦碟子注射液联合血管紧张素转化酶抑制剂/血管紧张素受体阻滞剂类药物治疗糖尿病肾病患者的临床观察  

Clinical Efficacy of Kudiezi Injection Combined with ACEI/ARB in Treating Dia⁃betic Nephropathy

作　　者：张淑娟 刘春月 闫燕[1] ZHANG Shu-juan;LIU Chun-yue;YAN Yan(The No.4 People′s Hospital of Hengshui,Hengshui Hebei 053000)

机构地区：[1]衡水市第四人民医院,河北衡水053000

出　　处：《世界中西医结合杂志》2023年第10期2086-2091,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：衡水市科技计划项目(2021014058Z)。

摘　　要：目的探讨苦碟子注射液联合血管紧张素转化酶抑制剂/血管紧张素受体阻滞剂(Angiotensin con⁃verting enzyme inhibitors/Angiotensin receptor blockers,ACEI/ARB)类药物治疗糖尿病肾病(Diabetic nephropathy,DN)的临床疗效及作用机制。方法选取2021年11月—2022年5月期间衡水市第四人民医院收治的100例DN患者作为研究对象,采用随机数字表法分为非暴露组与暴露组,每组各50例。非暴露组给予常规西医联合ACEI/ARB类药物治疗,在此基础上,暴露组联合苦碟子注射液治疗,两组患者均治疗2周。观察比较两组患者临床疗效、不良反应情况,治疗前后血糖指标[糖化血红蛋白(Glycosylated hemoglobin,HbA1c)、空腹血糖(Fasting blood glucose,FPG)、餐后2 h血糖(2 h postprandial blood glucose,2h PG)]、肾功能指标[血清肌酐(Serum creatinine,Scr)、尿素氮(Blood urea nitrogen,BUN)、尿白蛋白排泄率(Urinary albumin excretion rate,UAER)、尿微量白蛋白(microalbumin⁃uria,m-Alb)]、血液流变学指标[全血黏度(高切、中切、低切)、血浆黏度、纤维蛋白原(Fibrinogen,FIB)]、氧化应激指标[谷胱甘肽过氧化物酶(Glutathione peroxidase,GSH-Px)、丙二醛(Malondialdehyde,MDA)、超氧化物歧化酶(Superoxide dismutase,SOD)]、炎症因子指标[肿瘤坏死因子-α(Tumor necrosis factor-alpha,TNF-α)、白介素-6(Interleukin-6,IL-6)、白介素-8(Interleukin-8,IL-8)、可溶性细胞间黏附分子-1(Soluble intercellular adhe⁃sion molecule-1,sICAM-1)]水平变化。结果治疗后暴露组临床总有效率96.0%(48/50)明显高于非暴露组82.0%(41/50),差异有统计学意义(P<0.05)。治疗后两组患者血糖指标HbA1c、FPG、2 h PG水平均较治疗前降低,差异有统计学意义(P>0.05);且暴露组血糖指标HbA1c、FPG、2 h PG水平均明显低于非暴露组,差异有统计学意义(P<0.05)。治疗后两组患者肾功能相关指标血清Scr、BUN水平及尿UAER、m-Alb水平均较治疗前降低,差异有统计学意义(Objective To investigate the clinical effect and mechanism of Kudiezi Injection combined with angio⁃tensin-converting enzyme inhibitors/angiotensin receptor blockers(ACEI/ARB)in treating diabetic nephropathy(DN).Methods A total of 100 patients with DN treated in the No.4 People′s Hospital of Hengshui from November 2021 to May 2022 were randomized into a non-exposure group and an exposure group according to the random number table method,with 50 patients in each group.The non-exposure group was treated with conventional western medicine combined with ACEI/ARB,and the exposure group was treated with Kudiezi Injection on the basis of the therapy in the non-exposure group.Both groups were treated for 2 weeks,and the clinical efficacy and adverse reactions were compared between the two groups.The blood glucose indicators[glycosylated hemoglobin(HbA1c),fasting blood glucose(FPG),and 2h postprandial blood glucose(2h PG)],renal function indicators[serum creatinine(Scr),blood urea nitrogen(BUN),urinary albumin ex⁃cretion rate(UAER),and urinary microalbumin(m-Alb)],hemorheological indicators[whole blood viscosity(high,medi⁃um,and low shear),plasma viscosity,and fibrinogen(FIB)],oxidative stress indicators[glutathione peroxidase(GSH-Px),malondialdehyde(MDA),and superoxide dismutase(SOD)],and inflammation indicators[tumor necrosis factor-al⁃pha(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8),and soluble intercellular adhesion molecule-1(sICAM-1)]were measured before and after treatment.Results The total response rate in the exposure group(96.0%,48/50)was higher than that in the non-exposure group(82.0%,41/50;P<0.05).The levels of HbA1c,FPG,and 2h PG in the two groups after treatment were lower than those before treatment,and the exposure group had lower levels than the non-exposure group(P<0.05).After treatment,the Scr,BUN,UAER,and m-Alb levels,whole blood viscosity,plasma viscos⁃ity,and FIB level declined(P<0.05)and were lower in the exposure group than in the non-exposure group(P<0.05).The treatment in both gro

关 键 词：糖尿病肾病 苦碟子注射液 ACEI/ARB类药物 肾功能 血液流变学 氧化应激 炎症反应 

分 类 号：R587.2[医药卫生—内分泌]