周强++邵一川++干正琦++郭如雅++方立曙++张璐琰

[摘要] 目的 評估百令片治疗糖尿病早期肾病的疗效。 方法 选择该院门诊或住院的2型糖尿病早期肾病患者102例，随机分为治疗组与对照组，两组均为51例。两组患者均给予糖尿病饮食及常规治疗，治疗组额外予百令片 6片（2.7 g），3次/d，口服，16周为1疗程。用药前后测定患者的尿微量白蛋白/肌酐、血甘油三酯、低密度脂蛋白、空腹血糖、血肌酐含量及超敏CRP、GFR、TNF-α、TGFβ等指标。比较这些指标治疗前后的差异。结果 治疗组经治疗后超敏CRP、尿微量白蛋白/肌酐明显下降，与对照组比较差异有统计学意义（P<0.01）。治疗组患者血肌酐治疗后有明显下降（P<0.05），对照组血肌酐无明显下降（P>0.05），两组治疗后比较差异无统计学意义（P>0.05）；两组治疗后低密度脂蛋白胆固醇、甘油三酯均较治疗前差异有统计学意义（P<0.05），空腹血糖、糖化血红蛋白均较治疗前下降差异有统计学意义（P<0.01），但治疗后两组间差异无统计学意义（P>0.05）。两组治疗后GFR、血清炎症标志物TNF-α和纤维化标志物TGFβ水平均得到改善。 结论 百令片能明显减少糖尿病早期肾病患者的血肌酐、超敏CRP、尿微量白蛋白/肌酐、GFR、TNF-α；对早期糖尿病肾病有较好的辅助治疗作用。

[关键词] 糖尿病肾病；百令片；微量白蛋白尿； C反应蛋白

[中图分类号] R692 [文献标识码] A [文章编号] 1672-4062（2017）02（b）-0010-04

Observation on Curative Effect of Bailing Tablets in Treatment of Early Diabetic Nephropathy

ZHOU Qiang1， SHAO Yi-chuan1， GAN Zheng-qi1， GUO Ru-ya1， FANG Li-shu1， ZHANG Lu-yan2

1.Endocrinology Department， Jiaxing First Hospital， Jiaxing， Zhejiang Province， 314001 China；2.Department of Ophthalmology， Jiaxing First Hospital， Jiaxing， Zhejiang Province， 314001 China

[Abstract] Objective To evaluate the curative effect of Bailing Tablets in treatment of early diabetic nephropathy. Methods 102 cases of patients with early type II diabetic nephropathy were randomly divided into two groups with 51 cases in each， both groups were given the diabetes dieting and routine treatment， the treatment group added the additional six bailing tablets， three times per day， oral， 16 weeks were a treatment course， before and after medication， the microalbuminuria/ creatinine， blood triglyceride， low density lipoprotein， fasting blood glucose， serum creatinine content and hypersensitivity CRP、GFR、TNF-α、TGFβ of patients were measured， and the differences before and after treatment were compared. Results After treatment， the hypersensitivity CRP and microalbuminuria obviously decreased in the treatment group（P<0.01）， and the difference between the two groups was statistically significant（P<0.01）， and after treatment， the serum creatinine in the treatment group obviously decreased（P<0.05）， and the serum creatinine in the control group was not obviously decreased， （P>0.05）， and there were no obvious differences between the two groups after treatment（P>0.05）， after treatment， the differences in the low density lipoprotein cholesterin and triglyceride before and after treatment were statistically significant（P<0.05）， and the differences in the fasting blood glucose and glycosylated hemoglobin before and after treatment were obvious with statistical significance（P<0.01）， but the differences between the two groups after treatment were not statistically significant （P>0.05）， after treatment， the GFR， serum inflammatory marker TNF-α and fibrosis marker TGFβ level were improved in the two groups. Conclusion The bailing tablets can obviously decrease the serum creatinine， hypersensitivity CRP， microalbuminuria/ creatinine， GFR and TNF-α， which is of better adjunctive treatment function to the early diabetic nephropathy.

[Key words] Diabetic nephropathy； Bailing tablets； Microalbuminuria； C reactive protein

糖尿病肾病（diabetic kidney disease，DKD）是糖尿病最主要的微血管慢性并发症之一，是目前引起终末期肾病（end stage renal disease，ESRD）的首要原因[1]，最终导致糖尿病患者的死亡。据统计，其发病率逐年递增，严重威胁人类的健康，且已成为全球性公共卫生难题[2]。糖尿病早期肾病以微量白蛋白尿为特征，此期如果能及时发现，及时治疗，可延缓糖尿病肾病的进展。临床治疗以改善肾小球动脉硬化，减少尿蛋白，保护肾功能为主。氧……