盛丹虹 陳肖蓉

[摘要] 目的 探討黃芪片聯(lián)合厄貝沙坦治療早期糖尿病腎病的療效，及其對患者血清單核細胞趨化因子-1（MCP-1）、腫瘤壞死因子-α（TNF -α）水平的影響。 方法 選擇2019年1月至2020年6月期間我院收治的80例早期糖尿病腎病患者為研究對象，隨機分為觀察組（n=40）與對照組（n=40），均給予口服二甲雙胍片降糖治療，對照組患者予厄貝沙坦治療，觀察組在此基礎(chǔ)上聯(lián)合應(yīng)用黃芪片治療，比較兩組患者治療前后血肌酐及尿白蛋白排泄率（UAER）的變化，以及血清MCP-1、TNF-α水平的變化，比較兩組臨床療效及不良反應(yīng)發(fā)生率。 結(jié)果 治療后，UAER在兩組均下降明顯，且與對照組比較，觀察組UAER水平更低，差異有統(tǒng)計學意義（P<0.05）;兩組血肌酐水平在治療后與治療前比較無明顯差異（P>0.05）。觀察組治療總有效率為95.00%，明顯高于對照組的80.00%，差異有統(tǒng)計學意義（P<0.05）;兩組患者藥物不良反應(yīng)總發(fā)生率比較，差異無統(tǒng)計學意義（P>0.05）。治療后，兩組血清MCP-1、TNF-α水平與治療前比較均下降明顯，且與對照組比較，觀察組血清MCP-1、TNF-α水平更低，差異有統(tǒng)計學意義（P<0.05）。 結(jié)論 黃芪片聯(lián)合厄貝沙坦治療早期糖尿病腎病可降低患者血清MCP-1、TNF-α水平，減少尿蛋白的漏出，從而保護腎功能。

[關(guān)鍵詞] 糖尿病腎病;黃芪片;厄貝沙坦;蛋白尿;單核細胞趨化因子-1;腫瘤壞死因子-α

[中圖分類號] R587.2? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）24-0058-04

Efficacy of Astragalus tablet combined with irbesartan in the treatment of early diabetic nephropathy and its effect on serum MCP-1 and TNF-α levels

SHENG Danhong? ?CHEN Xiaorong

Department of Nephrology， Hangzhou Fuyang First People′s Hospital， Hangzhou? ?311400， China

[Abstract] Objective To investigate the efficacy of Astragalus tablet combined with irbesartan in the treatment of early diabetic nephropathy and its effect on serum monocyte chemotactic factor-1 （MCP-1） and tumor necrosis factor-α （TNF-α） levels in patients. Methods From January 2019 to June 2020， a total of 80 patients with early diabetic nephropathy admitted to our hospital were selected as the research objects， and they were randomly divided into the observation group （n=40） and the control group （n=40）. Both groups were given oral metformin tablets for hypoglycemic treatment. The control group was treated with irbesartan， and the observation group was treated with Astragalus tablets on this basis. The changes in serum creatinine and urinary albumin excretion rate （UAER）， serum MCP-1， and TNF-α levels of the two groups were compared before and after treatment. The clinical efficacy and the incidence of adverse reactions between the two groups were compared. Results After treatment， UAER decreased significantly in both groups. Compared with the control group， the observation group had a lower UAER level， and the difference was statistically significant （P<0.05）. Serum creatinine levels were not significantly different between the two groups after treatment and before treatment （P>0.05）. The total effective rate of treatment in the observation group was 95.00%， which was significantly higher than 80.00% in the control group （P<0.05）. There was no statistically significant difference in the total incidence of adverse drug reactions between the two groups of patients （P>0.05）. After treatment， serum MCP-1 and TNF-α levels in the two groups decreased significantly compared with those before treatment. Compared with the control group， the serum MCP-1 and TNF-α levels in the observation group were lower， and the difference was statistically significant （P<0.05）. Conclusion Astragalus tablet combined with irbesartan in the treatment of early diabetic nephropathy can reduce the levels of serum MCP-1 and TNF-α， reduce the leakage of urine protein， and protect renal function.