谢小菲 黄广英

【摘要】 目的：探討雷公藤多苷联合小檗碱对早期糖尿病肾病患者的临床治疗效果。方法：选取2017年2月-2018年2月本院收治的106例早期糖尿病肾病患者，应用随机数字表法分为对照组与研究组，每组各53例。对照组应用雷公藤多苷进行治疗，研究组应用雷公藤多苷联合小檗碱进行治疗。对比两组患者临床治疗效果、治疗前后两组患者血脂水平、血清中炎性因子水平以及两组患者尿白蛋白/肌酐比值（UACR）水平。结果：治疗前两组患者血脂水平比较差异均无统计学意义（P>0.05），治疗后两组LDL-C水平比较，差异无统计学意义（P>0.05），研究组患者血脂HDL-C、TG、TC水平均优于对照组（P<0.05）。治疗前两组患者TNF-α、IL-18、IL-6水平比较，差异均无统计学意义（P>0.05）;治疗后研究组细胞中上述炎性因子水平均低于对照组（P<0.05）。治疗前两组患者UACR水平比较，差异无统计学意义（P>0.05），治疗后研究组患者UACR下降幅度显著高于对照组（P<0.05）。结论：雷公藤多苷联合小檗碱治疗早期糖尿病肾病患者，可以有效抑制血清细胞中的炎性因子，改善微循环、阻止微血栓形成。雷公藤多苷联合小檗碱用药，可使早期糖尿病肾病患者的UACR下降，临床疗效显著。

【关键词】 雷公藤多苷; 小檗碱; 早期糖尿病肾病; 治疗效果

【Abstract】 Objective：To investigate the clinical effect of Tripterygium Wilfordii Polyglycosides combined with Berberine on early diabetic nephropathy.Method：106 patients with early diabetic nephropathy admitted to our hospital from February 2017 to February 2018 were divided into control group and research group by random number table method，53 cases in each group.The control group was treated with Tripterygium Wilfordii Polyglycosides，while the study group was treated with Tripterygium Wilfordii Polyglycosides combined with Berberine.The clinical efficacy，blood lipid level，serum inflammatory factors and urinary albumin/creatinine ratio（UACR）were compared between the two groups before and after treatment.Result：Before treatment，there was no significant difference in blood lipid level between the two groups（P>0.05）.After treatment，there was no significant difference in LDL-C level between the two groups（P>0.05）;the levels of HDL-C，TG and TC in the study group were better than those of control group（P<0.05）.Before treatment，there were no significant differences in the levels of TNF-α，IL-18 and IL-6 between the two groups（P>0.05）;after treatment，the levels of inflammatory factors in the study group were lower than those of control group（P<0.05）.Before treatment，there was no significant difference in UACR level between the two groups（P>0.05）.After treatment，UACR level in the study group was significantly higher than that in the control group（P<0.05）.Conclusion：Tripterygium Wilfordii Polyglycosides combined with Berberine in the treatment of early diabetic nephropathy can effectively inhibit inflammatory factors in serum cells，improve microcirculation and prevent microthrombosis.Tripterygium Wilfordii Polyglycosides combined with Berberine can reduce UACR in patients with early diabetic nephropathy，and the clinical effect is significant.

【Key words】 Tripterygium Wilfordii Polyglycosides; Berberine; Early diabetic nephropathy; Therapeutic effect

First-authors address：Dongguan Peoples Hospital，Dongguan 523000，China

doi：10.3969/j.issn.1674-4985.2019.16.010

随着我国经济发展，人民生活方式的变化，糖尿病发病率逐年飙升至2013年的10.4%，而合并糖尿病肾病的患者为慢性肾脏病和终末期肾病的主要原因，占糖尿病患者的20%～40%[1]，此人群亦随着糖尿病发病率上升而不断扩大。糖尿病肾病早期表现为微量蛋白尿，如不及时干预治疗，进一步发展为临床蛋白尿期，将会出现不可逆的肾脏损害。糖尿病肾病的发病原因仍在研究阶段，有相关医学研究结果显示，糖尿病肾病患者发病阶段，在糖脂代谢紊乱的下游环节，慢性炎症会出现，可能与患病晚期出现的慢性肾功能衰竭有关[2]。在糖尿病肾病早期对患者进行科学合理的综合治疗，特别是针对调节糖脂代谢、慢性炎症方面，可以降低糖尿病肾病的进一步发展。雷公藤多……