The Clinical Curative Effect Of Tripterygium Wilfordii On The Proteinuria In Diabetic Nephropathy

As one of the most serious complications of Diabetes mellitus (DM),Diabetic nephropathy (DN) is an important cause of death. In Europe and theUnited States and other developed countries, DN is the leading cause of ESRD,in our country it is the second cause of ESRDf but the proportion is increasingrapidly.More than30%-50%DM patients complicate with DN in more than10years of DM. The early clinical manifestations of DN are often invisible,so thediagnosis is difficult. Once entering the massive proteinuria, the condition isoften irreversible. Compared with other renal disease, DN gets more rapidprogression,and requires renal replacement therapy earlier which bring heavyburdens to the families and society. Therefore, how to control DN is the maintask that we face.The main clinical characteristic features is Proteinuria which can indicatesthe severity of DN.Meanwhile proteinuria itself also can accelerate theprogression of DN.Except for the controlling of the blood pressure, bloodglucose, blood lipid of the traditional treatments of DN,how to decreaseproteinuria would be significant.Objective：RAS inhibitor is now widely used in clinic to control DNproteinuria, and can effectively delay the progress of DN.By searching the comparison of the effect by using RAS inhibitor singly and TW plus RASinhibitor, we predict to provide the clinical evidence for the prevention andtreatment of DN,and also prove the feasibility of TW plus RAS inhibitortreatment.Methods：We selected130cases of DN patients in our hospital from2008September to2012September that divided into60cases of early DN group(24hurinary protein target:150~500mg/24h) and70cases of clinical DN group(24hurinary protein target:≥500mg/24h).Each group was divided into ARBtreatment group (Group ARB) and TW plus ARB group (Group TW plusARB).All the130cases accepted Valsartan,80mg/d. In Group TW plusARB,Valsartan,80mg/d and TW,1～2mg·kg-1·d-1was given.The dose of TWwas reduced by half after12weeks.24h urinary protein target was the mainobservation, and we compared the curative effect of early DN group and theclinical DN group by the application of ARB and TW plus ARB.Results：Compared with Group ARB, Group TW plus ARB got thereduction of the proteinuria of DN more obviously,and also higher remissionrate.Conclusions：For the patients of early DN and clinical DN, comparedwith ARB monotherapy,TW plus ARB treatment could reduce proteinuria moreeffectively.