血栓通与抵克立得治疗早期糖尿病肾病的对比研究

作者	单位
郎江明	广东省佛山市中医院!广东528000
曹海伟	广东省佛山市中医院!广东528000
魏爱生	广东省佛山市中医院!广东528000
黄彪	广东省佛山市中医院!广东528000
谭峰	广东省佛山市中医院!广东528000
吴军	广东省佛山市中医院!广东528000

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中文摘要:

目的 :探讨抑制血小板聚集的药物血栓通 (三七总皂甙 ,panaxnotoginseng ,PNS)和抵克立得 (Ticlid)治疗早期糖尿病肾病 (DN)的疗效及机理。方法 :5 8例早期DN患者随机分为抵克立得组 (2 8例 ,抵克立得 2 5 0mg,每日 1次 )和血栓通组 (3 0例 ,血栓通每日 8ml,加 2 5 0ml生理盐水静脉滴注 ) ,采用对比研究方法 ,观察治疗早期DN的疗效和相关指标变化。结果 :治疗后 ,抵克立得组和血栓通组的血栓素B2 (TXB2 )均显著下降 (P <0 0 1 ) ,且抵克立得组下降明显高于血栓通组 (P <0 0 5 ) ;6 酮前列腺素F1α(6 K PGF1α)上升 ,T/K比值变化显著(P <0 0 1 )。两组患者的尿白蛋白 (ALB) ,β2 -微球蛋白 (β2 MG)均明显下降 (P <0 0 1 )。血α1 微球蛋白 (α1 MG)亦下降 (P <0 0 1 )。抵克立得组治疗前后尿ALB与T/K值呈现显著正相关(r=0 41 ,P <0 0 1 )。血α1 -MG和T/K亦呈现显著正相关 (r =0 3 4,P <0 0 5 ) ,血栓通组未有此种关系。结论 :血栓通和抵克立得治疗DN ,有助于恢复体内TXA2 /PGI2 的平衡 ,改善微循环 ,降低DN患者全血粘度 ,以减少早期DN患者尿ALB排泄 ,延缓DN发展。

英文摘要:

Objective: To explore the ameliorative effect and mechanism of Panax notoginseng (PNG) and ticlid in treating early diabetic nephropathy (DN). Methods: Fifty eight patients were divided randomly into two groups, 28 patients of the ticlid group treated with ticlid 250 mg orally, once a day and 30 patients of the PNG group treated with PNG 8 ml in 250 ml of normal saline intravenous drip once a day. The therapeutic effect and relative indexes of the two groups were observed and compared. Results: After treatment, in both groups, the thromboxane B 2 markedly reduced and was more prominent in the ticlid group (P<0 05), while the 6 keto prostaglandin F 1α increased obviously, so as to cause a significant lowering of T/K ratio, P<0 01. Levels of urinary albumin, β 2 microglobulin and blood α 1 microglobulin of both groups were lowered significantly, P<0 01. A significant positive linear correlation was found in the ticlid group between urinary albumin and T/K ratio (r=0.41, P<0 01), as well as in blood α 1 microglobulin with T/K ratio (r=0.34, P<0 05), while it was not found in the PNG group. Conclusion: Ticlid and PNG were beneficial to resume the balance of T/K and improve microcirculation, reduce whole blood viscosity and decrease urinary albumin so as to retard the progress of DN.

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