摘要
目的探讨不同剂量阿托伐他汀联合益气养阴方治疗糖尿病肾病(DN)的疗效及对患者炎性因子水平、血液流变学和肾功能指标的影响。方法选取2016年10月—2017年12月于南方医科大学中西医结合医院肾病科收治的DN患者90例,根据随机数字表法将其分为低剂量组、中剂量组和高剂量组,每组30例。所有患者均给予盐酸二甲双胍片、益气养阴汤进行治疗,在此基础上低剂量组、中剂量组和高剂量组分别给予10、20和40 mg/d的阿托伐他汀进行治疗。比较3组患者的炎性因子水平、血液流变学、肾功能指标、临床疗效和不良反应。结果治疗1个月后,高剂量组的超敏C反应蛋白、肿瘤坏死因子-α及白介素-6水平低于中剂量组和低剂量组(P <0.05);高剂量组的全血黏度低切、全血黏度中切、全血黏度高切及血浆黏度低于中剂量组和低剂量组(P<0.05);高剂量组尿白蛋白排泄率、血尿素氮及血肌酐水平低于中剂量组和低剂量组(P<0.05)。3组患者的总有效率和不良反应比较,差异无统计学意义(P>0.05)。结论阿托伐他汀联合益气养阴方可有效改善DN患者的炎症反应、血流动力学和肾功能,且临床疗效高,高剂量的阿托伐他汀联合益气养阴方改善程度最明显,安全性较好。
Objective To investigate the effect of Atorvastatin combined with Yiqi Yangyin prescription on diabetic nephropathy(DN)and on the levels of inflammatory factors,hemorheology and renal function.Methods Ninety cases of DN patients who were treated in Department of Nephropathy in Integrated Traditional Chinese and Western Medicine Hospital of Southern Medical University from October 2016 to December 2017 were selected.According to the random digital table method,the patients were divided into a small-dose group,a medium-dose group and a large-dose group,with 30 cases in each group.All patients were treated with Metformin Hydrochloride Tablets and Yiqi Yangyin prescription,on this basis,the small-dose group,mediumdose group and large-dose group were treated with Atorvastatin 10,20 and 40 mg/d respectively.The inflammatory factors,hemorheology,renal function,clinical efficacy and adverse reactions were compared among the three groups.Results After 1 month of treatment,the levels of hypersensitive C-reaction protein,tumor necrosis factor-αand interleukin-6 in the large-dose group were lower than those in the medium-dose group and the small-dose group(P<0.05).The whole blood viscosity(low shear,middle shear and high shear)and plasma viscosity in the largedose group were lower than those in medium-dose group and the small-dose group(P<0.05).Urinary albumin excretion rate,blood urea nitrogen and serum creatinine levels in the large-dose group were lower than those in the medium-dose group and the small-dose group(P<0.05).There was no significant difference in the total effective rate or adverse reaction among the three groups(P>0.05).Conclusions Atorvastatin combined with Yiqi Yangyin prescription can effectively improve the inflammatory reaction,hemodynamics and renal function in the patients with DN.And the high-dose Atorvastatin provides the most significant improvement without increasing the adverse reaction.
作者
陈杰彬
吕佩佳
赖伟兰
李成杰
魏连波
Jie-bin Chen;Pei-jia Lü;Wei-lan Lai;Cheng-jie Li;Lian-bo Wei(Department of Nephropathy,Integrated Traditional Chinese and Western Medicine Hospital,Southern Medical University,Guangzhou,Guangdong 510315,China;Department of Emergency,University City Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou,Guangdong 510006,China)
出处
《中国现代医学杂志》
CAS
2018年第35期92-97,共6页
China Journal of Modern Medicine
