目的 探讨雷公藤多苷联合替米沙坦治疗糖尿病肾病的临床疗效。方法 选取2012年10月—2014年10月天津市第一中心医院内分泌科收治的2型糖尿病肾病患者126例,随机分为对照组(64例)和治疗组(62例)。对照组在基础治疗上口服替米沙坦片80 mg/次,1次/d。治疗组在对照组治疗基础上口服雷公藤多苷片,20 mg/次,3次/d。两组均连续治疗12周。观察两组的临床疗效,同时比较两组治疗前后血肌酐(Scr)、血尿素氮(BUN)、24 h尿蛋白定量、肾小球滤过率(GFR)、糖化血红蛋白(HbA1c)的水平变化。结果 治疗后,对照组和治疗组的总有效率分别为85.94%、96.77%,两组比较差异具有统计学意义(P <0.05)。治疗后,两组患者24 h尿蛋白定量、Scr、BUN、HbA1c水平出现明显降低,GFR较治疗前升高,同组治疗前后比较差异具有统计学意义(P <0.05);且治疗组这些观察指标的改善程度优于对照组,两组比较差异有统计学意义(P <0.05)。结论 雷公藤多苷联合替米沙坦治疗糖尿病肾病具有较好的临床疗效,可有效降低患者尿蛋白水平,无不良反应,具有一定的临床推广应用价值。

Objective To observe the effect of tripterygium glycosides combined with telmisartan in treatment of diabetic nephropathy. Methods Patients (126 cases) with diabetic nephropathy in Department of Endocrinology of Tianjin First Central Hospital from October 2012 to October 2014 were randomly divided into control (64 cases) and treatment groups (62 cases). The patients in the control group were po administered with Telmisartan Tablets on the basis of foundation treatment, 80 mg/time, once daily. The patients in the treatment group were po administered with Tripterygium Glycosides Tablets, 20 mg/time, three times daily. Two groups were treated for 12 weeks. After treatment, the efficacy was evaluated, and the changes of Scr, BUN, 24 h urine protein quantitative, GFR, and HbA1c in two groups before and after treatment were compared. Results After treatment, the efficacies in the control and treatment groups were 85.94% and 96.77%, respectively, and there was difference between two groups (P < 0.05). After treatment, Scr, BUN, 24 h urine protein quantitative, and HbA1c in two groups were significantly reduced. While GFR was significantly increased, and the difference was statistically significant in the same group (P < 0.05). And these indicators in treatment group improved better than those in the control group, with significant differences between two groups (P < 0.05). Conclusions Tripterygium glycosides combined with telmisartan has good clinical efficacy in treatment of diabetic nephropathy, and can effectively reduce the urinary protein level, which has certain clinical application value.

天津市卫计委科技基金资助项目(2013kz025)