| ObjectiveDiabetic nephropathy(diabetic nephrophy,DN) is the result of diabetic microangiopathy,which is also known as diabetic glomerulosclerosis.DN is the most common complications of diabetes,after the course of diabetes 10 to 20 years,the incidence of DN is account for 30%to 50%.According to statistics,DN is the leading cause of kidney disease in patients starting renal replacement therapy and affects 25%to 50%western patients and 6%to 10%chinese patients,lt also increase the mortality of cardiovascular disease.Proteinuria is a strong and independent predictor of decreased renal function.proteinuria itself may aggravate the glomerular sclerosis and tubulointerstitial injury,protein filtration and reabsorption may lead to inflammation and the release of vasoactive substances,proliferation of fibrous tissue,interstitial inflammation and damage to mesangial cells.The incidence of proteinuria in type 2 diabetes is up to 56%.As for DM patients,after 7 years of clinical proteinuria,about 50%patients will enter into end stage renal failure,the resulting renal failure is also rapidly rising.Therefore,interventions for the treatment of diabetic nephropathy as a complication of diabetes prevention is becoming more and more significant.The purppose of this study is to observe the method of activating blood to solve stasis to treat the type of blood stasis in patients with early diabetic nephropathy.Meanwhile,to explore the intervention role and the possible mechanism for optimizing the treatment of diabetic nephropathy to provide a reasonable program.MethodAccording to 1999《WHO diagnostic criteria for diabetes》,diabetic nephropathy Mogensen stages and 1992《new drugs of traditional Chinese medicine clinical research guiding principles》,60 incipient DN patients were chosen from in-and-out patients coming from endocrinology department in the Chinese medical hospital of GuangDong Province from April of 2007 to April of 2009.These selected patients were randomly divided into 2 groups(Group A, B).On the basis of low-protein,Low-fatand low salt diet,these groups are given hypoglycemic therapy according to blood glucose.(mainly by use of Glimepiride,Gliquidone,Metformin,or insulin).Besides,Group A(30 cases, lcase dropped out)was given Lotensin 10-20mg qd which based on the level of blood pressure;B group(30 cases,1 cases dropped out) was given Fu Fang Xueshuantong capsule 3 tablets and Lotensin at the same time.and all of the two groups separately received each kind of treatment mentioned above for 3 months.Age,HbAlc,urinary albumin,average blood pressure and renal function of patients in each group were measured statistically,and there were no significant difference(P＞0.05),which meant the comparison between groups.(P＞0.05),however.After 3 months later,The main index of observation include the blood stasis syndrom scores,urinary albumin,serum creatinine, glycosylated hemoglobin(HbAlc),blood coagulation,blood lipids,blood pressure,high-sensitivity C-reactive protein.Resultsthree months later,blood stasis symptom score,urinary albumin,HbAlc, serum creatinine,coagulation,blood lipids,blood pressure and high-sensitivity C-reactive protein improve apparentlly comparing with pre-treatment(P＜0.05);compared to groupA,As for some laboratory tests, group B has a great significant changes(P＜0.05).Meanwhile,there is no adverse reactions in three groups during the treatment.ConclusionIn this study,the combination treatment includes basic Control of blood glucose treatment,Angiotensin-converting enzyme inhibitor and the method of activating blood to solve stasis to treat the type of blood stasisin patients with diabetic nephropathy can obviously improve clinical symptoms and reduce HbAlc,blood pressure,urine albumin,improve blood hypercoagulability, hyperlipidemia,reduce kidney inflammation,and protection of renal function. Used in clinical response,no relevant Xueshuantong capsule-related adverse events occurred,we can see its clinical application is safe. |
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