Clinical Efficacy Of Carthamin Yellow Combined With Enazepril In Treating Early Diabetic Nephropathy

Objective:Diabetic Kidney disease(DKD)is the most common complications of diabetes mellitus(DM).The lesion may involve glomerulus,renal vessels and interstitium.DKD has become an important cause of end-stage renal disease and brings huge challenges and financial burden to patients and society.The pathogenesis of DKD is complex,which is related to glucose and lipid metabolism disorder,cytokines levels abnormal and hemodynamic change.Carthamin yellow is the main component of safflower,which has the effect of relax vascular smooth muscle,expand blood vessels and improve microcirculation.The purpose of this study is to observe the clinical efficacy of carthamin yellow combined with benazepril in treating early DKD and to investigate the influence of carthamin yellow on renal function inflammation indexes and hemorheology indexes of patients with DKD.This study may be offering some useful clinical data for treatment of DKD.Methods:136 cases of DKD patients who were hospitalized at Shijiazhuang Great Wall hospital were enrolled in this study from January2017 to December 2017.The patients were diagnosed on base of diagnostic criteria for DM and DKD.All patients were diagnosed?period of DKD according to Mogensen standard stage.The 136 patients were randomly divided into two groups,with 68 cases in each group.The patients received diabetes knowledge education and basic treatment such as diet control,glucose control.Patients in Benazepril group were treated with Benapril tablet10 mg a day for 4 weeks and patients in Combination group were plus carthamin yellow 100mg with normal saline 250mL intravenous drip once a day besides Benapril tablet 10 mg a day for 4 weeks.The basic data of gender,age,height,weight and illness course were collected.Fasting venous blood was collected from two groups of patients before and after treatment.The Fasting blood glucose(FBG),2-hour postprandial blood glucose(2hPG)and glyeosylated hemoglobin(HbA1_C),creatinine(Scr),urea nitrogen(BUN)and?2-Microglobulin(?2-MG)were detected.?1-Microg-lobulin(?1-MG),urinary?2-MG and urinary Albumin/creatinine ratio(ACR)were compared.The C-reaction protein(CRP)and tumor necrosis factor-a(TNF-a)and interleukin-6(IL-6)were detected.The changes of hemorheo-logical indexes in the two groups were observed before and after treatment.After 4 weeks`treatment,the therapeutic effect and drug safety were analyzed.Statistical analyses were done with SPSS19.0 and statistically significant differences sets P<0.05.Results:1.FBG,2hPG,HbA1_C and HOMA-IR levelsCompared with before treatment,the level of FBG,2hPG and HbA1c had no significantly changed(P>0.05),the HOMA-IR was significantly reduced(P<0.05),the HOMA-IR of Combination group decreased significantly more(P<0.05).2.Scr,BUN and eGFR levelsThere were no statistically significant differences in Scr,BUN and eGFR between the two groups before and after treatment(P>0.05).There was no statistically significant change in Scr,BUN and eGFR(P>0.05).3.Urine?1-MG,serum 2-MG,urine 2-MG levelsCompared with before treatment,the urine?1-MG,serum 2-MG,urine2-MG levels were reduced significantly in two groups(P<0.05).There were statistically significant differences in urine?1-MG,serum 2-MG,urine 2-MG levels between the two groups after treatment(P<0.05).4.ACR levelAfter treatment,the ACR of Combination group and Benazepril group reduced significantly all(P<0.05),and Combination group reduced more(P<0.05).5.Inflammation indexesAfter treatment,the serum CRP,TNF-?and IL-6 of Combination group and Benazepril group reduced significantly all(P<0.05),and the Combination group reduced more(P<0.05).6.Hemorheological conditionAfter treatment,the hemorheological of two groups reduced significantly all(P<0.05),and the Combination group reduced more(P<0.05).7.Untoward effectDuring the treatment,the untoward effect rate of Combination group(4.41%)and Benazepril group(8.82%)had no statistically difference in untoward effect rate between the two groups during the treatment(P>0.05).Conclusion:The therapeutic effect of safflower yellow in treatment of DKD is mainly achieved by improving insulin resistance,reducing inflammatory factors and improving hemorheology.Carthamin yellow combined with Benazepril has obvious curative effect in treatment of early DKD.It can effectively reduce ACR,also has high security and good application value.