黄芪片联合厄贝沙坦治疗早期糖尿病肾病的疗效及对血清MCP-1、TNF-α水平的影响

盛丹虹 陈肖蓉

[摘要] 目的 探討黄芪片联合厄贝沙坦治疗早期糖尿病肾病的疗效，及其对患者血清单核细胞趋化因子-1（MCP-1）、肿瘤坏死因子-α（TNF -α）水平的影响。 方法 选择2019年1月至2020年6月期间我院收治的80例早期糖尿病肾病患者为研究对象，随机分为观察组（n=40）与对照组（n=40），均给予口服二甲双胍片降糖治疗，对照组患者予厄贝沙坦治疗，观察组在此基础上联合应用黄芪片治疗，比较两组患者治疗前后血肌酐及尿白蛋白排泄率（UAER）的变化，以及血清MCP-1、TNF-α水平的变化，比较两组临床疗效及不良反应发生率。 结果 治疗后，UAER在两组均下降明显，且与对照组比较，观察组UAER水平更低，差异有统计学意义（P<0.05）;两组血肌酐水平在治疗后与治疗前比较无明显差异（P>0.05）。观察组治疗总有效率为95.00%，明显高于对照组的80.00%，差异有统计学意义（P<0.05）;两组患者药物不良反应总发生率比较，差异无统计学意义（P>0.05）。治疗后，两组血清MCP-1、TNF-α水平与治疗前比较均下降明显，且与对照组比较，观察组血清MCP-1、TNF-α水平更低，差异有统计学意义（P<0.05）。 结论 黄芪片联合厄贝沙坦治疗早期糖尿病肾病可降低患者血清MCP-1、TNF-α水平，减少尿蛋白的漏出，从而保护肾功能。

[关键词] 糖尿病肾病;黄芪片;厄贝沙坦;蛋白尿;单核细胞趋化因子-1;肿瘤坏死因子-α

[中图分类号] R587.2          [文献标识码] B          [文章编号] 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.