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1、提要目的:观察在西医基础治疗的基础上加用中药提取物雷公藤多甙治疗1型糖尿病肾病与2型糖尿病肾病的临床疗效。方法:采用前瞻性随机对照方法,将符合诊断标准的40例2型糖尿病肾病患者分为2组,对照组予降糖、降压等西医基础治疗;治疗组在西医基础治疗的基础上加用中药提取物雷公藤多甙。由于检查方法及1型糖尿病肾病的病号较少,只统计到符合诊断标准的10例1型糖尿病肾病患者分为2组,对照组予降糖、降压等西医基础治疗;治疗组在西医基础治疗的基础上加用中药提取物雷公藤多甙。观察治疗前后患者24小时尿蛋白、肾功能、胰岛细胞抗体、抗炎因子、超敏C反应
2、蛋白等相关指标的变化。结果:(1)由于1型糖尿病肾病患者收集较少,不具有统计学意义。(2)1)2型糖尿病肾病治疗组总有效率75%,对照组总有效率25%,两组比较有统计学差异(P<0.05);2)治疗组降低24尿蛋白水平、尿微量白蛋白、抗炎因子、超敏C反应蛋白的疗效优于对照组,统计学上有差异(P<0.05),与对照组相比降低内生肌酐清除率、血肌酐、尿素氮的差异不明显(P>0.05)。3)患者空腹血糖、餐后2h血糖、糖化血红蛋白降低与对照组相比无明显差异(P>0.05)。4、对患者血压和血脂的影响与对照组无明显差异(P>0.05)
3、。关键词糖尿病肾病;中西医结合;雷公藤多甙Clinicalstudyontriptolideintreatmentofdiabeticnephropathyintype1andtype2diabeticnephropathySpeciality:MedicineofDNAuthor:wangchenTutor:ProfessorxuyunshengAbstractObjective:Thisstudyaimstoobservetheclinicalresultsoftriptolideintreatmentofdiabetic
4、nephropathyintype1andtype2diabeticnephropathy.Method:Useaprospectiverandomizedmethodtodivide40casesoftype2diabeticnephropathypatientswhomeetthecriteriaforthediagnosisintotwogroups.20patientswereclassifiedintocontrolgroupwhoweretreatedwithWesternmedicinefoundationstr
5、eatment.20patientswereclassifiedintotreatmentgroupwhoweretreatedwithWesternmedicinefoundationtreatmentandtriptolide.sincetheexaminationmethodandthepatientsoftype1diabeticnephropathyless,onlycollect10patientswhomeetthediagnosticstandardtodivideintotwogroup.5patientsw
6、ereclassifiedintocontrolgroupwhoweretreatedwithWesternmedicinefoundationstreatment.5patientswereclassifiedintotreatmentgroupwhoweretreatedwithWesternmedicinefoundationtreatmentandtriptolide.Patientswereobservedthechangebeforeandaftertreatmentof24hPRO,mAlb,Ccr,Scr,BU
7、N,TNF-α,Hs-CRPandsoon.Results:(1)Asaresultoftype1diabeticpatientswithnephropathycollectedless,don'thavestatisticalsignificance.(2)1)Thetotalclinicaleffectiverateoftreatmentgroupis75%,whichisbetterthanthatofcontrolgroupwithstatisticatl(P<0.05).2)Thetreatmentgroupinre
8、ducing24hPRO,mAlb,TNF-α,Hs-CRPisbetterthanthecontrolgroup(P<0.05),butinCcr,Scr,BUN,thereisnosignificantdifferencebetweenthetwogroup(P>0.05