Effect Of Selenium Yeast Capsule Combined With Irbesartan On Urinary Protein In Patients With Type 2 Diabetic Nephropathy

BackgroundThe early feature of diabetes nephropathy(DN)is a slight increase in albumin excretion in urine.Therefore,early control of blood sugar and blood pressure can reduce urinary protein and delay of DN development.The clinical effect of angiotensin receptor blocker(ARB)on early DN has been proved.Oxidation stress is also closely related to the development of DN,increase the number of reactive oxygen species(ROS),and affect the antioxidant defense system.Selenium is an important component of some antioxidant enzymes and selenium-P proteins.Therefore,selenium supplementation can enhance antioxidant effects,but its clinical research on DN is less reported.This paper aims to observe the effect of selenium yeast capsule combined with Irbesartan on urinary protein in early type 2 diabetic nephropathy patients.ObjectiveCompare the effects of selenium yeast capsules combined with Irbesartan and single use Irbesartan on urinary microalbumin,urinary microalbumin / creatinine in early type 2 diabetic nephropathy patients,and observe blood sugar,glycosylated hemoglobin,blood pressure,blood lipids,and renal function and adverse reactions.Methods68 patients with type 2 diabetes mellitus combined with stage III diabetic nephropathy were selected as the study subjects.By looking at the random number table,they were randomly and equally divided into the observation group A and the control group B,34 patients in the A and B group.Both groups conducted diabetes education and instructed them to control diet,exercise,give regular treatment such as hypoglycemic and/or hypertensive,lipid-reducing drugs,timely adjust hypoglycemic programs,and monitor blood sugar levels in patients.Group A was given selenium yeast capsules 100 ?g orally once a day and Irbesartan tablets 150 mg,orally once a day.Group B was given Irbesartan tablets 150 mg,orally once a day.Observe and compare the changes in urinary microalbumin,urinary microalbumin / creatinine,blood sugar,glycosylated hemoglobin,blood lipids,liver function,renal function,blood pressure,and adverse reactions in the two groups before treatment(within 1 week),3 months after treatment,and 6 months after treatment.Results1.There was no significant difference in the ratio of urine microalbumin and urine microalbumin / creatinine before treatment between two groups of patients(P>0.05).After 3 months treatment,the ratio of urine microalbumin and urine microalbumin / creatinine in both groups decreased significantly compared to those before treatment(P<0.05),but there was no significant difference between two groups(P>0.05).2.There was no significant difference in the ratio of urine microalbumin and urine microalbumin / creatinine before treatment between two groups of patients(P>0.05).After 6 months treatment,the ratio of urine microalbumin and urine microalbumin / creatinine in both groups decreased significantly compared to those before treatment(P<0.05),and there was significant difference between two groups(P<0.05).Group A decreased more than Group B.3.There was no significant difference in blood pressure before treatment between two groups of patients(P>0.05).After 6 months treatment,blood pressure in both groups decreased significantly compared to that before treatment(P<0.05),but there was no significant difference between two groups(P>0.05).4.There was no significant difference in their HbA1 c,fasting blood sugar,and 2 hours after meal blood sugar before treatment between two groups of patients(P>0.05).After 6 months treatment,there was no significant decrease in HbA1 c,FPG,and 2hPBG in two groups(P>0.05),and there was no significant difference between two groups(P>0.05).5.There was no significant difference in their LDL-C,HDL-C,TG,and TC before treatment between two groups of patients(P>0.05).After 6 months treatment,there was no significant decrease in LDL-C,HDL-C,TG,and TC in two groups(P>0.05),and there was no significant difference between two groups(P>0.05).6.During the experiment,the incidence of adverse reactions in group A and group B were 20.59% and 23.53%,respectively.There was no significant difference between the two groups(P>0.05).None of them met the criteria of suspension and withdrawal.Neither kidney function nor electrolyte abnormality was observed.ConclusionsIn the treatment of early type 2 diabetic nephropathy,selenium yeast capsules combined with Irbesartan tablets reduced urinary microalbumin and urinary microalbumin / creatinine ratios significantly,and was superior to Irbesartan alone.The treatment should last 6 months at least.