摘要
目的分析雷公藤多苷片联合血管紧张素转换酶(ACE)抑制剂、钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂对糖尿病肾病Ⅳ期患者肾功能和蛋白尿水平的影响。方法抽取2019年3月至2021年6月焦作煤业(集团)有限责任公司中央医院收治的糖尿病肾病Ⅳ期患者124例,按照随机数字表法分为中西结合组与西医组,每组62例。西医组采用ACE抑制剂、SGLT2抑制剂治疗,中西结合组在西医组治疗基础上加用雷公藤多苷片。比较两组治疗效果、肾功能、蛋白尿情况、症状评分、不良反应发生率。结果中西结合组总有效率(93.55%,58/62)高于西医组(79.03%,49/62),P<0.05。治疗后,中西结合组血尿素氮、血肌酐低于西医组,肾小球滤过率高于西医组(P<0.05)。治疗后,中西结合组24 h尿微量白蛋白、24 h尿蛋白定量、大量蛋白尿、浮肿、多尿、浑身乏力症状评分低于西医组(P<0.05)。中西结合组不良反应发生率(3.23%,2/62)与西医组(6.45%,4/62)比较差异未见统计学意义(P>0.05)。结论雷公藤多苷片联合ACE抑制剂、SGLT2抑制剂治疗糖尿病肾病Ⅳ期患者,可更好地降低尿蛋白,减少肾小球滤过率的下降,保护肾功能,从而减轻临床症状,治疗效果显著,且具有安全性。
Objective To analyze the effects of tripterygium wilfordii polyglycoside tablets combined with angiotensin converting enzyme(ACE)inhibitor and sodium-glucose cotransporter 2(SGLT2)inhibitor on renal function and proteinuria in diabetic nephropathy stage IV.Methods A total of 124 patients with stage IV diabetic nephropathy treated in Central Hospital of Jiaozuo Coal Industry(Group)Co.,Ltd.from March 2019 to June 2021 were selected and divided into integrated Chinese and western medicine group and western medicine group by random number table method,with 62 cases in each group.The western medicine group was treated with ACE and SGLT2 inhibitor,and the integrated Chinese and western medicine group was treated with tripterygium wilfordii polyglycoside tablets based on the treatment of the western medicine group.The curative effect,renal function,proteinuria,symptom score,inflammatory factor levels and incidence of adverse reactions were compared between the two groups.Results The total effective rate of the integrated Chinese and western medicine group was 93.55%(58/62),higher than 79.03%(49/62)of the western medicine group(P<0.05).After treatment,blood urea nitrogen,serum creatinine,24-hour urine microalbumin,and 24-hour urine protein quantification in the integrated Chinese and western medicine group were lower than those in the western medicine group,and the glomerular filtration rate was higher than those in the western medicine group(P<0.05).After treatment,scores of symptoms of proteinuria,edema,polyuria and fatigue in the integrated Chinese and western medicine group were lower than those in the western medicine group(P<0.05).There was no significant difference in the incidence of adverse reactions between the integrated Chinese and western medicine group(3.23%,2/62)and the western medicine group(6.45%,4/62),P>0.05.Conclusions Tripterygium glycosides tablet combined with ACE and SGLT2 inhibitors in the treatment of patients with diabetic nephropathy can improve renal function,relieve clinical symptoms,and it has significant therapeutic effects and safety.
作者
马文莉
Ma Wenli(Department of Nephropathy,Rheumatology and Immunology,Central Hospital of Jiaozuo Coal Industry(Group)Co.,Ltd.,Jiaozuo 454000,China)
出处
《中国实用医刊》
2022年第16期120-122,F0003,共4页
Chinese Journal of Practical Medicine
