Abstract:
Objective To explore the efficacy of Quzhuo Qingyuan Decoction plus telmisartan for diabetes nephropathy （DN） and examine its influences on renal function and renal hemodynamics.
Methods From March 2021 to March 2022, 120 DN patients were recruited and randomized into two groups of study and control （n = 60 each）. Control group received telmisartan while study group （n = 60） had telmisartan plus Quzhuo Qingyuan Decoction. Clinical efficacies, parameters of renal function, renal hemodynamics and glucose metabolism and drug safety of two groups were compared.
Results Total effective rate of study group was higher than that of control group （91.67%, 55/60） vs （73.33%, 44/60）, P＜0.05. After treatment, serum creatinine （Scr） of patients in study and control groups （75.06 ± 7.15） μmol/L, （81.26 ± 8.28） μmol/L vs （89.65 ± 9.16） μmol/L, （89.77±9.25） μmol/L, blood urea nitrogen （BUN） （7.15 ± 0.65） mmol/L, （11.81 ± 1.56） mmol/L vs （26.59 ± 5.65） mmol/L, （26.91 ± 5.42） mmol/L, urinary albumin creatinine （UACR） （65.13 ± 3.59） mg/g, （115.31 ± 3.65） mg/g vs （157.41 ± 9.36） mg/g, （157.75 ± 9.28） mg/g and 24-hour urine protein quantification （0.26 ± 0.08） g, （1.69 ± 0.32） g vs （3.75 ± 0.28） g, （2.61 ± 0.69） g declined markedly. Study group was lower than control group （P＜0.05）. After treatment, minimal diastolic blood flow velocity （Vmin） （16.75 ± 4.25） cm/s, （13.83 ± 4.16） cm/s vs （11.22 ± 3.77） cm/s, （11.29 ± 3.75） cm/s, maximal diastolic blood flow velocity （Vmax） （49.66 ± 5.64） cm/s, （45.35 ± 6.29） cm/s vs （41.28 ± 11.64） cm/s, （41.34 ± 11.75） cm/s and average flow velocity （27.73 ± 4.26） cm/s, （24.66 ± 5.87） cm/s vs （20.16 ± 5.13） cm/s, （20.25±5.24） cm/s spiked markedly. Study group was higher than control group （P＜0.05）. However, resistance index （RI） in study and control groups （0.63 ± 0.06, 0.76 ± 0.09 vs 0.87 ± 0.21, 0.85 ± 0.19）, pulse index （PI） （1.26 ± 0.17, 1.48 ± 0.25 vs 1.69 ± 0.32, 1.74 ± 0.36） and Vmax/Vmin （2.96 ± 0.81, 3.28 ± 0.91 vs 3.68 ± 1.02, 3.66 ± 1.01） declined markedly and study group was lower than control group. After treatment, fasting blood glucose （FPG） was in study and control groups （5.26 ± 0.65） mmol/L, （7.08 ± 1.05） mmol/L vs （7.27 ± 1.19） mmol/L, （7.25 ± 1.16） mmol/L. The levels of glycated hemoglobin （HbA1c） （7.04 ± 1.39）%, （8.25 ± 1.46）% vs （10.17 ± 1.71）%, （10.19 ± 1.68）% and postprandial 2-hour blood glucose （2 hPPG） （9.26 ± 1.43） mmol/L, （11.29 ± 1.68） mmol/L vs （14.21 ± 2.16） mmol/L, （14.19 ± 2.15） mmol/L were significantly lower than pre-treatment and study group was lower than control group （P＜0.05）. The incidence of adverse reactions was lower in study group than that in control group （5.00%, 3/60） vs （16.67%, 10/60）, χ2 = 4.227, P = 0.040）.
Conclusions Quzhuo Qingyuan Decoction plus telmisartan is efficacious for DN. With a high drug safety, it may improve renal function, regulate hemodynamics and improve the control of glucose metabolism.
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