| Object ive:Two semi-Tang on early type2diabetic nephropathy and insulin sensitivity were observed.Methods:62cases of early type2diabetic nephropathy were randomly divided into two groups:control group (n=30), to be daily30mg the hydrochloric pioglitazone tablets morning oral administration of1; observation group (n=32), oral administration of two semi-soup decoction a day, two consecutive12weeks of treatment, and at the same time be oral antihypertensive drugs, blood pressure was well controlled (systolic blood pressure<130mmHg, diastolic blood pressure <80mmHg). Other basic treatment such as diet, exercise, all the same.Patients in both groups before and after treatment on urinary albumin (mAlb),24-hour urinary protein excretion (24hU-TP), serum creatinine (Scr), glomerular filtration rate (GFR), renal indicators; glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG),2hours after breakfast, blood glucose (PPG), fasting insulin (FINS), insulin resistance index (HOMA-IR), glucose and insulin index of islet (3-cell function index (HOMA-IS); and weight (Wt), body mass index (BMI), C-reactive protein (CRP), lipid analysis (TC, TG, HDL, LDL), such as the above two sets of indicators related factors were measured. The clinical symptoms recorded before and after treatment changes, complete the clinical symptoms score table, integrating the analysis and comparison.MAlb,24hU-TP determination were used immunoturbidimetric assay and the biuret method; glucose, FINS determination were used dry chemical method and radioimmunoassay (RIA); CRP and lipids were immune turbidimetric method and enzyme determination. HOMA-IR, HOMA-IS, BMI, respectively, using their respective formula calculation.The data collected to conduct a comprehensive statistical analysis using SPSS13.0statistical analysis software. Results:(1) two sets of clinical symptom score and efficacy comparison:①The clinical symptom score:after treatment, the clinical symptom score of the two groups of patients before treatment, decreased significantly, there are significant differences (P<0.05). Which observed clinical symptom score of the group of patients than the control group was significant difference (P<0.05).:Two half soup and pioglitazone both improved clinical symptoms, the role of two semi-Tang in this respect superior to pioglitazone.②clinical efficacy:The observation group of32cases, effective in10cases in which clinical, effective19cases,3cases, the total efficiency of90.62%; control group (30cases), clinical effective in7cases,15cases,8cases, The total efficiency of73.33%. X2test, P<0.05, the observed total effective rate was higher than that in the control group.(2) two groups of patients before and after comparison of kidney-related indicators: before and after treatment, after treatment mAlb,24hU-TP has decreased significantly (P<0.01). And the control group observation group mAlb,24hU-TP decreased after treatment, are slightly higher than that of the control group, but no significant difference (P>0.05). GRF at the same time two groups of patients than before treatment were decreased, the decline in which the observed group differences (P<0.05), but the control group dropped somewhat but the difference was not significant (P>0.05). Show that:two semi-soup and pioglitazone tablets can reduce the DKD microalbuminuria, and both considerable efficacy. Two half soup can DKD early increase in glomerular filtration rate to ease the the DKD early glomerular filtration, high perfusion state.(3) comparison of glucose and insulin resistance level before and after treatment:①blood glucose levels and glycosylated hemoglobin:two groups of patients with blood glucose levels and glycosylated hemoglobin level after treatment has improved, the difference was significant (P<0.05), of which the control group, the fasting plasma glucose and glycosylated hemoglobin improvement in the observation group the observation group have a lower effect on fasting plasma glucose, but less than the control group, also has a hypoglycemic effect on postprandial blood glucose, and the control group fairly. Show that:two half soup can to a certain extent to reduce fasting and postprandial blood glucose, HbA1c, FPG, and HbA1c improvement is less than pioglitazone.(D levels of insulin resistance by comparison:after treatment, two groups of patients with HOMA-IR index, FINS than before treatment decreased HOMA-IS index were significantly increased compared with before treatment, the difference was significant (P<0.05); but there were no significant differences (P>0.05). Show that:two half soup and pioglitazone tablets can improve the degree of insulin resistance, and considerable efficacy.Kidney and blood glucose, insulin indicators related factors(4) two groups of patients before and after comparison:CD The comparison:two groups of patients before and after body weight and inflammatory factors, including the control group of patients with Wt, BMI, compared with the pre-treatment decline, there are significant differences (P<0.05). Wt of the observed group, BMI before treatment, a slight decrease, but the difference was not significant. Two sets of CRP compared with before treatment were decreased (P <0.05), the observation group than the control group more differences (P<0.05): two semi-Tang on the weight change is not obvious, but can reduce the body’s inflammatory response.②two groups of patients before and after lipid changes:After treatment, the control group and observation group LDL, TG and the TC compared to before treatment slightly decreased the HDL rise is not obvious, the difference was significant (P <0.05). Which the control group decreased slightly more than the observation group, but the difference was not significant. Show that:the early type2diabetic nephropathy dyslipidemia, two semi-soup slightly lower TC, TG and LDL levels, improve their status of lipid disorders, but this effect is slightly inferior to pioglitazone.(5) safety observations:There were no obvious adverse reactions, the patient can tolerate, patients in both groups completed the experiment, there is no interruption of treatment because of serious adverse reactions of the cases. By blood analysis before and after treatment, urine, stool, liver and kidney function tests, results showed that during the treatment period, two groups of patients with liver and kidney function, blood analysis, urine, and stool were within the normal range and found no abnormal changes.Conclusion:This study found that two half soup can improve the clinical symptoms of early type2diabetic nephropathy; can reduce urinary protein and reduce diabetic kidney disease (DKD) early increase in glomerular filtration rate, improve DKD early glomerular hyperperfusion high filtration state, thereby preventing glomerulosclerosis; can lower blood sugar levels to a certain extent, increase the insulin sensitivity of DKD patients, to improve the IR state, and efficacy in improving insulin sensitivity is equivalent to pioglitazone in lowering blood glucose levels inferior to pioglitazone rosiglitazone. Two half soup can reduce the body’s inflammatory response; slight improvement in the status of lipid disorders, but this is inferior to pioglitazone; speculated that the two half of the soup may be the inflammatory response, improve dyslipidemia, mechanisms to achieve these improvements the DKD early glomerular hyperperfusion, hyperfiltration status, increase the role of the DKD insulin sensitivity. Two semi-soup without significant adverse reactions and side effects, a good safety profile, clinical use in early type2diabetic nephropathy. |
PDF Full Text Request