百令片联合雷公藤多甙片治疗IV期糖尿病肾病临床效果观察.docVIP

百令片联合雷公藤多甙片治疗IV期糖尿病肾病临床效果观察 　　[摘要] 目的 观察百令片联合雷公藤多甙治疗IV期糖尿病肾病（diabetic kidney disease，DKD）的临床疗效。方法 收集2015年8―12月期间在该院肾脏内科确诊为IV期DKD的患者共27例，给予百令片（5片/次，3次/d联合雷公藤多甙片[1 mg/（kg?d），分3次口服]连续服用6个月。分别在用药前、用药后3个月和6个月时测定患者24 h尿总蛋白定量（24 h-UTP）、尿N-乙酰-β-氨基葡萄糖苷酶（尿NAG酶）、血超敏C-反应蛋白（血hs-CRP）、尿微量白蛋白/肌酐（UACR）、血白蛋白（血ALB），比较其差异，用来评价两药连用对IV期DKD的临床治疗效果并观察其不良反应。结果 治疗后患者24 h-UTP、尿NAG酶及血hs-CRP、UACR较治疗前相比，显著下降，且差异有统计学意义。27例患者血ALB显著升高，且治疗前后差异有统计学意义（P0.05）。结论 百令片联合雷公藤多甙片治疗IV期DKA临床效果显著且安全，值得临床推广使用。 　　[关键词] 百令片；雷公藤多甙片；糖尿病肾病 　　[中图分类号] R259 [文献标识码] A [文章编号] 1672-4062（2017）03（b）-0076-03 　　[Abstract] Objective To observe the clinical effect of bailing tablets and tripterygium wilfordii glycoside tablets in treatment of diabetic nephropathy during the IV stage. Methods 27 cases of DKD patients during the IV stage in our hospital from August to December 2015 were selected and were given the bailing tablets （ 5 every time， three times daily） and tripterygium wilfordii glycoside tablets[1 mg/（kg?d）， oral three times] for consecutive six months， and the 24 h-UTP， urine NAG， serum hs-CRP， UACR， serum albumin were measured before medication， in 3 months and 6 months after medication， and the clinical treatment effect was evaluated and the adverse reactions were observed. Results After treatment， the 24 h-UTP， urine NAG， serum hs-CRP and UACR obviously decreased compared with those before treatment， and the differences were statistically significant， and of 27 cases， the serum ALB obviously increased and the difference before and after treatment was statistically significant（P0.05）. Conclusion The clinical effect of bailing tablets and tripterygium wilfordii glycoside tablets in treatment of diabetic nephropathy during the IV stage is obvious with safety， which is worth clinical promotion and application. 　　[Key words] Bailing tablets； Tripterygium wilfordii glycoside tablets； Diabetic nephropathy 　　DKD是糖尿病最常?的慢性微血管并发症之一，从初期微量蛋白尿到终末期肾功能衰竭，其临床进展共分为5期[1]。其病因及致病机制复杂，主要包括糖代谢异常、血流动力学改变、细胞因子及生长因子作用、遗传因素等方面。同时，涉及