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目的:观察糖肾保元方合雷公藤多苷片对糖尿病肾病(DN)IV期患者临床症状、蛋白尿及血脂的影响。方法:105例患者随机分为洛丁新组、雷公藤组及治疗组各35例,各组患者继续原有降糖治疗,血压高者予硝苯地平缓释片降压。在此基础上,洛丁新组应用洛丁新,雷公藤组应用雷公藤多苷片,治疗组应用糖肾保元方合雷公藤多苷片治疗。30日为1个疗程,连用3个疗程,观察3组各项指标变化。结果:治疗组较洛丁新组尿蛋白、血白蛋白、血肌酐、中医症状积分及血脂明显改善,有统计学意义(P<0.01)。治疗组较雷公藤组尿蛋白、血白蛋白、血肌酐、中医症状积分及血脂明显改善,有统计学意义(P<0.05或<0.01)。结论:糖肾保元方配合雷公藤多苷片是治疗DNIV期的有效方法,既可明显减少蛋白尿,提高血白蛋白,缓解症状,同时还可改善脂代谢,从而保护肾功能,延缓疾病进展。
OBJECTIVE: To observe the clinical symptoms, proteinuria and serum lipids in patients with stage Ⅳ diabetic nephropathy (DN). Methods: One hundred and fifty-five patients were randomly divided into two groups, 35 patients in each group. The patients in each group continued the treatment of hypoglycemic. The patients with high blood pressure were given nifedipine sustained-release tablets. On this basis, the new group of application of Luoding Ding Luodin, Tripterygium application of Tripterygium glycosides tablets, the treatment group with the application of Tangshenbao yuan triptolide tablets. 30 days for a course of treatment, once every 3 courses, observe the changes in the 3 groups of indicators. Results: The urinary albumin, serum albumin, serum creatinine, symptom scores and blood lipid in the treatment group were significantly improved compared with the newest group (P <0.01). Compared with tripterygium wilfordii group, urinary protein, serum albumin, serum creatinine, TCM symptom score and blood lipid in treatment group were significantly improved (P <0.05 or <0.01). Conclusion: Tangshenbaoyin prescription combined with Tripterygium Wilfordii glycosides tablets is an effective method for the treatment of DNIV, can significantly reduce proteinuria, raise serum albumin, relieve symptoms, but also can improve lipid metabolism, thus protecting renal function and disease retardation progress.