尿毒清联合 ARB／ACEI治疗糖尿病肾病大量蛋白尿的疗效观察

摘要

Objective To observe the effects of Uremic Clearance Granule combined with angiotensin receptor blockers (ARB) or angiotensin converting enzyme inhibitors (ACEI) in treating different period of diabetic nephropathy (DN ) .Methods 46 patients with DN were divided into the control group and the treatment group ,23 cases in each group .The two groups were given the rou-tine hypoglycemic therapy .The control group was treated with ACEI or ARB ,while the treatment group was given Uremic Clear-ance Granule 5 g each time ,four times daily for successive 4 weeks .Then the indexes of serum creatinine ,blood urea nitrogen ,cysta-tin-C ,microalbumin and 24 h urine total protein at 24 h before and after treatment were observed .Results The microalbumin and 24 h urine total protein after treatment in the two groups were reduced compared with before treatment (P<0 .01) .In the patients with the stage Ⅲ of DN ,the urine protein decrease after treatment had no statistical difference between the two groups (P>0 .05) . In the patients with the stage Ⅳ of DN ,on the basis of ACEI or ARB adding Uremic Clearance Granule could significantly decrease the urine protein(P<0 .05) .Conclusion ACEI or ARB combined with Uremic Clearance Granule has definite effect for treating massive proteinuria of DN .%目的：观察尿毒清颗粒联合血管紧张素转换酶抑制剂（ACEI）或血管紧张素受体拮抗剂（ARB）类药物对糖尿病肾病不同分期的疗效。方法将46例糖尿病肾病患者分为对照组和治疗组，每组各23例。两组患者均常规降糖治疗，对照组给予ACEI或ARB类药物；治疗组在对照组治疗的基础上联用尿毒清颗粒每日4次，每次5 g ，连续服药4周，观察治疗前后24 h尿微量蛋白、24 h尿蛋白定量、血肌酐、尿素氮、胱抑素的变化。结果两组治疗后24 h尿微量蛋白、24 h蛋白定量均较治疗前减少（P＜0．01）。对于糖尿病肾病Ⅲ期患者，治疗组和对照组在减少尿蛋白的治疗上差异无统计学意义（P＞0．05），对于糖尿病肾病Ⅳ期患者，治疗组较对照组尿蛋白明显减少（P＜0．05）。结论 ACEI或ARB类药物联合尿毒清颗粒治疗糖尿病肾病大量蛋白尿患者疗效确切。