阿卡波糖联合糖脉康治疗Ⅰ期和Ⅱ期糖尿病肾病的临床疗效及对患者氧化应激水平的影响

摘要

目的 观察阿卡波糖联合糖脉康颗粒治疗Ⅰ期和Ⅱ期糖尿病肾病的临床疗效及对患者氧化应激的影响.方法 选择2012年1月～2015年12月湖州市南浔区练市人民医院内科收治的188例Ⅰ期和Ⅱ期DN患者,随机分为对照组和治疗组,各94例,对照组给予西医常规治疗糖尿病肾病,降压药采用洛汀新.治疗组在对照组治疗基础上加服阿卡波糖和糖脉康颗粒.2组疗程均为8 w.检测治疗前后48 h患者尿中尿微量白蛋白(UAER)、肌酐与尿微量白蛋白的比值(ACR),血清氧化物歧化酶(SOD)、过氧化氢酶(CAT)及丙二醛(MDA).结果 治疗组临床疗效总有效率91.5％,显著高于对照组的68.1％,2组总有效疗效率比较,差异有统计学意义(P<0.05);治疗组UAER及ACR水平均低于对照组(P<0.05);治疗后,观察组血清SOD、CAT水平高于对照组,MDA水平低于对照组,差异均有统计学意义( P <0.05);2组均未见不良反应情况发生.结论 阿卡波糖联合糖脉康颗粒治疗DN患者疗效显著,可改善治疗糖尿病肾脏病变,氧化应激损伤与糖尿病肾病作用机制有关.%Objective To observe the acarbose combined therapy with sugar pulse phase Ⅰ and phase Ⅱ clinical curative effect of diabetic nephropathy and the effects of oxidative stress on the patients.Methods 188 cases of phase Ⅰ and phase Ⅱ DN patients were selected in hangzhou xixi hospital endocrinology from January 2012 to December 2012,randomly divided into control group and treatment group,94 cases in each groups,the control group given conventional western medicine treatment of diabetic nephropathy,antihypertensive agents using lotensin.Treatment group was treated in the control group on the basis of taking acarbose and sugar pulse tablet.The control group and treatment group a course of eight weeks.Testing for 48 hours patients before and after the urine trace albumin in the urine(UAER)and creatinine ratio(ACR)with urine trace albumin,serum oxide dismutase(SOD),catalase(CAT)and malondialdehyde(MDA).Results The total effective rate was 91.5％in the treatment group,which was significantly higher than that in the control group(68.1％),the total effective rate of the two groups was statistically significant(P<0.05); The levels of UAER and ACR in the treatment group were lower than those in the control group(P<0.05); After treatment,the levels of serum SOD and CAT in the treatment group were higher than those in the control group,the MDA level was lower than that in the control group,the difference was statistically significant(P<0.05); No adverse reactions occurred in the two groups.Conclusion Acarbose combined with Tangmaikang granules in the treatment of DN patients with significant effect,can improve the treatment of diabetic nephropathy,the levels of oxidative stress injury is related to diabetic nephropathy mechanism.