目的 探討金芪降糖片聯(lián)合替米沙坦片治療糖尿病腎病的臨床療效。方法 選取2012年9月—2014年9月來天津市職業(yè)病防治院就診的2型糖尿病腎病患者130例,隨機分為對照組(64例)和治療組(66例),對照組在常規(guī)治療的基礎上口服替米沙坦片,80 mg/次,1次/d;治療組在對照組的基礎上口服金芪降糖片7片/次,3次/d。觀察兩組的臨床療效,同時比較各項指標24 h尿微量白蛋白(24 h UMA)、血肌酐(Scr)、血尿素氮(BUN)、尿白蛋白排泄率(UAER)、糖化血紅蛋白(HbA1c)的變化情況。結果 對照組的總有效率為82.28%,治療組的總有效率為95.94%,明顯高于對照組,具有統(tǒng)計學意義(P< 0.05)。治療后,與同組治療前比較,兩組的24 h UMA、Scr、BUN、UAER、HbA1c水平均出現(xiàn)明顯降低,且差異具有統(tǒng)計學意義(P< 0.05)。治療后,治療組的24 h UMA、UAER明顯低于對照組(P< 0.05),而治療組的Scr、BUN、HbA1c與對照組治療后比較差異無統(tǒng)計學意義。結論 金芪降糖片聯(lián)合替米沙坦能有效地降低尿蛋白,改善患者的臨床癥狀和相關指標,同時具有良好的安全性和耐受性,具有一定的臨床推廣應用價值。

Objective To investigate the clinical efficacy of Jinqi Jiangtang Tablets combined with Telmisartan Tablets in treatment of early diabetic nephropathy. Methods Patients (130 cases) with type 2 diabetic nephropathy in Occupational Disease Prevention Hospital in Tianjin from September 2012 to September 2014 were randomly divided into control (66 cases) and treatment groups (64 cases). On the basis of conventional treatment, the patients in the control group were po administered with Telmisartan Tablets, 80 mg/time, once daily. The patients in treatment group were po administered with Jinqi Jiangtang Tablets, 7 tablets/time, three times daily. After treatment, the efficacy was evaluated, and 24 h urine microalbumin (24 h UMA), serum creatinine (Scr), blood urea nitrogen (BUN), urinary albumin excretion rate (UAER), and glycosylated hemoglobin (HbA1c) in two groups were compared. Results The total effective rate of treatment group was 95.94%, while that of control group was 82.28%. And there was significant difference between two groups (P < 0.05). After treatment, the levels of 24 h UMA, Scr, BUN, UAER, and HbA1c were significantly decreased compared with same group before treatment, and the difference was statistically significant (P < 0.05). After treatment, the levels of 24 h UMA and UAER in treatment group were lower than those in control group significantly (P < 0.05), while there were no significant difference between Scr, BUN, and HbA1c in two groups. Conclusion Jinqi Jiangtang Tablets combined with telmisartan can reduce urinary protein, improve the clinical symptoms and related indicators of patients, and also has good safety and tolerability, which has a certain clinical application value.