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目的 探讨金水宝胶囊联合依帕司他片治疗糖尿病肾病的临床疗效。方法 选取2014年9月—2017年4月商丘市第一人民医院收治的糖尿病肾病患者172例,随机分为对照组和治疗组,每组各86例。对照组口服依帕司他片,50 mg/次,1次/d。治疗组在对照组治疗的基础上口服金水宝胶囊,3粒/次,3次/d。两组患者均连续治疗8周。观察两组的临床疗效,比较两组的血糖、肾功能指标、24 h尿微量蛋白定量、血清氧化指标和血清抗氧化指标。结果 治疗后,对照组和治疗组的总有效率分别为75.6%、93.0%,两组比较差异有统计学意义(P<0.05)。治疗后,两组空腹血糖、糖化血红蛋白水平均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组血糖指标明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清肌酐(Scr)、尿素氮(BUN)、胱抑素C(Cys-C)、血清β2微球蛋白(β2-MG)、24 h尿微量蛋白定量、尿蛋白排泄率(UAER)水平均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组活性氧(ROS)、脂质过氧化氢(LHP)和晚期蛋白氧化产物(AOPPS)水平均显著下降,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组血清氧化指标明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组超氧化物歧化酶(SOD)、维生素E(VitE)、维生素C(VitC)和总抗氧化能力(T-AOC)水平均显著升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组血清抗氧化指标明显高于对照组,两组比较差异具有统计学意义(P<0.05)。结论 金水宝胶囊联合依帕司他片治疗糖尿病肾病具有较好的临床疗效,可改善肾功能,增强抗氧化能力,降低氧化反应,具有一定临床推广应用价值。
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[Abstract]
Objective To investigate the effects of Jinshuibao Capsules combined with Epalrestat Tablets in treatment of diabetic nephropathy. Methods Patients (172 cases) with diabetic nephropathy in Shangqiu First People's Hospital from September 2014 to April 2017 were randomly divided into control and treatment groups, and each group had 86 cases. Patients in the control group were po administered with Epalrestat Tablets, 50 mg/time, once daily. Patients in the treatment group were po administered with Jinshuibao Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacies were evaluated, and blood glucose, renal function indexes, 24 h urine microprotein, serum oxidation indexes, and serum antioxidant indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 75.6% and 93.0%, respectively, and there was difference between two groups (P<0.05). After treatment, the levels of fasting blood sugar and glycosylated hemoglobin in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And blood glucose index leveles in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of Scr, BUN, Cys-C, β2-MG, 24 h urine microprotein and UAER in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the renal function indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of ROS, LHP, and AOPPS in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the serum oxidation indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of SOD, VitE, VitC, and T-AOC in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the serum antioxidant indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). Conclusion Jinshuibao Capsules combined with Epalrestat Tablets has clinical curative effect in treatment of diabetic nephropathy, can improve renal function, enhance antioxidant capacity, and reduce oxidation reaction, which has a certain application value.
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