目的 探讨百令胶囊联合利拉鲁肽治疗早期糖尿病肾病的临床效果。方法 选取2014年1月—2015年2月佛山市高明区人民医院内分泌科收治的早期糖尿病肾病患者160例,随机分为对照组和治疗组,每组各80例。对照组皮下注射利拉鲁肽注射液,第1周0.6 mg/d,第2周1.2 mg/d,第3周1.8 mg/d,此后维持1.8 mg/d。治疗组在对照组治疗基础上口服百令胶囊,2粒/次,3次/d。两组均连续治疗2个月。观察两组的临床疗效,同时比较两组治疗前后体质量指数(BMI)、总胆固醇(TC)、三酰甘油(TG)、24 h尿白蛋白定量(Upr)、血尿素氮(BUN)、血肌酐(Scr)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、膀胱抑素C(CysC)、尿微量白蛋白(mAlb)的变化。结果 治疗后,对照组和治疗组的总有效率分别为80.00%、91.25%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组BMI、TC、Upr、BUN、Scr、HbA1c、CysC、mAlb较治疗前显著下降,同组治疗前后差异均有统计学意义(P<0.05),且治疗组这些观察指标的改善程度优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后两组TG、FBG均显著降低,同组治疗前后差异均有统计学意义(P<0.05),但治疗后两组比较差异无统计学意义。对照组和治疗组的不良反应发生率分别为15.00%、3.75%,两组比较差异具有统计学意义(P<0.05)。结论 百令胶囊联合利拉鲁肽治疗早期糖尿病肾病具有较好的临床效果,能改善患者的脂代谢、糖代谢及肾功能相关指标,且安全性较高,具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Bailing Capsules combined with liraglutide in treatment of early diabetic nephropathy. Methods Patients (160 cases) with early diabetic nephropathy in Department of Endocrinology of People's Hospital of Gaoming District in Foshan City from January 2014 to January 2015 were randomly divided into control and treatment groups, and each group had 80 cases. The patients in the control group were sc administered with Liraglutide Injection, 0.6 mg/d in the first week, 1.2 mg/d in the second week, 1.8 mg/d in the third week, then the maintain dosage was 1.8 mg/d. The patients in the treatment group were po administered with Bailing Capsules, 2 grains/time, three times daily. The patients in two groups were treated for 2 months. After treatment, the clinical efficacies were evaluated, and the changes of BMI, TC, TG, Upr, BUN, Scr, FBG, HbA1c, CysC, and mAlb in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 80.00% and 91.25%, respectively, and there were differences between two groups (P< 0.05). After treatment, BMI, TC, Upr, BUN, Scr, HbA1c, CysC, and mAlb in two groups were significantly decreased, and the difference was statistically significant in the same group (P< 0.05). After treatment, those observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P< 0.05). TG and FBG in two groups were significantly decreased, and the difference was statistically significant in the same group (P< 0.05). But there was no statistically significant difference between two groups after treatment. The incidence of adverse reactions in control and treatment groups were 15.00% and 3.75%, respectively, and there were differences between two groups (P< 0.05). Conclusion Bailing Capsules combined with liraglutide has clinical curative effect in treatment of early diabetic nephropathy, and can improve the indicators related lipid metabolism, sugar metabolism and renal function with high safety, which has a certain clinical application value.