目的 探讨金芪降糖片联合替米沙坦片治疗糖尿病肾病的临床疗效。方法 选取2012年9月—2014年9月来天津市职业病防治院就诊的2型糖尿病肾病患者130例,随机分为对照组(64例)和治疗组(66例),对照组在常规治疗的基础上口服替米沙坦片,80 mg/次,1次/d;治疗组在对照组的基础上口服金芪降糖片7片/次,3次/d。观察两组的临床疗效,同时比较各项指标24 h尿微量白蛋白(24 h UMA)、血肌酐(Scr)、血尿素氮(BUN)、尿白蛋白排泄率(UAER)、糖化血红蛋白(HbA1c)的变化情况。结果 对照组的总有效率为82.28%,治疗组的总有效率为95.94%,明显高于对照组,具有统计学意义(P< 0.05)。治疗后,与同组治疗前比较,两组的24 h UMA、Scr、BUN、UAER、HbA1c水平均出现明显降低,且差异具有统计学意义(P< 0.05)。治疗后,治疗组的24 h UMA、UAER明显低于对照组(P< 0.05),而治疗组的Scr、BUN、HbA1c与对照组治疗后比较差异无统计学意义。结论 金芪降糖片联合替米沙坦能有效地降低尿蛋白,改善患者的临床症状和相关指标,同时具有良好的安全性和耐受性,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Jinqi Jiangtang Tablets combined with Telmisartan Tablets in treatment of early diabetic nephropathy. Methods Patients (130 cases) with type 2 diabetic nephropathy in Occupational Disease Prevention Hospital in Tianjin from September 2012 to September 2014 were randomly divided into control (66 cases) and treatment groups (64 cases). On the basis of conventional treatment, the patients in the control group were po administered with Telmisartan Tablets, 80 mg/time, once daily. The patients in treatment group were po administered with Jinqi Jiangtang Tablets, 7 tablets/time, three times daily. After treatment, the efficacy was evaluated, and 24 h urine microalbumin (24 h UMA), serum creatinine (Scr), blood urea nitrogen (BUN), urinary albumin excretion rate (UAER), and glycosylated hemoglobin (HbA1c) in two groups were compared. Results The total effective rate of treatment group was 95.94%, while that of control group was 82.28%. And there was significant difference between two groups (P < 0.05). After treatment, the levels of 24 h UMA, Scr, BUN, UAER, and HbA1c were significantly decreased compared with same group before treatment, and the difference was statistically significant (P < 0.05). After treatment, the levels of 24 h UMA and UAER in treatment group were lower than those in control group significantly (P < 0.05), while there were no significant difference between Scr, BUN, and HbA1c in two groups. Conclusion Jinqi Jiangtang Tablets combined with telmisartan can reduce urinary protein, improve the clinical symptoms and related indicators of patients, and also has good safety and tolerability, which has a certain clinical application value.