维生素D3注射液联合黄葵胶囊治疗糖尿病肾脏病早期白蛋白尿的疗效观察

    The effect of vitamin D3 combined with okra capsule treatment on early protein uria in the patients with type 2 diabetic kidney disease

    • 摘要: 目的 观察维生素D3注射液和黄葵胶囊联合治疗糖尿病肾脏病(DKD)早期白蛋白尿的临床疗效。方法 将120例DKD早期白蛋白尿患者采用盲选均分方法分为治疗组60例和对照组60例。治疗组给予维生素D3注射液肌肉注射(40万单位/次,每4周1次)并给予黄葵胶囊口服(2.5 g/次,每日3次),对照组仅口服黄葵胶囊(2.5 g/次,每日3次),两组均治疗16周。观察治疗前后两组血清25-羟基维生素D3、尿白蛋白/肌酐比值(UACR)、超敏C反应蛋白(hs-CRP)、血肌酐、尿素氮和糖化血红蛋白(HbA1c)等指标的变化。结果 治疗16周后,两组患者UACR、hs-CRP均明显下降(P<0.05),治疗组25-羟基维生素D3的质量浓度(31.0±4.9)ng/ml较治疗前(19.0±1.4)ng/ml明显上升(P<0.05);两组治疗前后血压、血肌酐、尿素氮水平无明显变化(P>0.05)。对照组治疗后UACR、hs-CRP分别为(86.8±8.4)mg/g、(0.41±0.11)mg/dl,治疗组治疗后UACR、hs-CRP分别为(52.9±6.8)mg/g、(0.32±0.08)mg/dl;与对照组比较,治疗组UACR、hs-CRP均显著下降(P<0.05)。结论 维生素D3注射液联合黄葵胶囊治疗DKD优于单用黄葵胶囊,能有效降低早期尿白蛋白和改善炎症因子,延缓DKD的进展。

       

      Abstract: Objective To observe the clinical effect of vitamin D3 combined with okra capsules treatment on early protein uria patients with diabetic kidney disease(DKD). Methods 120 proteinuria patients with early DKD were randomly divided into treatment group(60 cases) and control groups(60 cases) by blind separation method. The treatment group was given vitamin D3 intramuscular injection(400 thousand units per time, once per four weeks)combined with okra capsules (2.5 g per time,tid),The control group was only given okra capsules(2.5 g per time,tid).Both groups were treated for 16 weeks. Before and after treatment,the levels of 25-(OH)D3,UAlb/Cr(UACR),hs-CRP,serum creatinine,blood urea nitrogen and HbA1c were observed. Results After 16 weeks treatment, the levels of UACR,hs-CRP were significantly decreased in two groups after treatment(P<0.05).In treatment group, the concentration of 25-(OH)D3 (19.0±1.4) ng/ml before treatment was significantly increased to (31.0±4.9) ng/ml after treatment(P<0.05). The levels of blood pressure,SCr and BUN had no significant changes before and after treatment in two groups (P>0.05).In control group, the level of UACR、hs-CRP is (86.8±8.4) mg/g、(0.41±0.11) mg/dl. Intreatment group, the level of UACR、hs-CRP is (52.9±6.8) mg/g、(0.32±0.08) mg/dl. Compared with control group, UACR,hs-CRP were significantly decreased in treatment group (P<0.05). Conclusions Vitamin D3 combined with okra capsule treatment on proteinuria patients with early DKD is superior to single okra capsule treatment,could effectively reduce early proteinuria and inflammatory reaction, delay the progression of DKD.

       

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