【摘要】 目的 观察黄芪注射液并用贝那普利对早期糖尿病肾病(DN)的临床疗效及其作用机理。方法 将40例早期DN患者随机分为对照组(20例)和治疗组(20例)，对照组为常规西药和贝那普利治疗，治疗组加用黄芪注射液。比较两组血压、空腹血糖(FBG)、血肌酐(Scr)、尿素氮(BUN)、血浆白蛋白、尿白蛋白排泄率(UAER)、尿β2微球蛋白(β2-MG)的改变。结果 两组在治疗前各项指标差异无显著性；经4周治疗后，两组血压、UAER、尿β2-MG较治疗前均有明显下降(P<0.05或P<0.01)，且治疗组较对照组下降更明显；FBG、Scr、BUN治疗组较对照组稍低，但差异无显著性(P>0.05)。结论 黄芪注射液并用贝那普利联合常规西药治疗早期DN临床疗效比常规西药联合贝那普利疗效显著，其机理与降低TGF-β1，改善DN早期的肾脏高灌注、高滤过等有关。

    【关键词】 黄芪注射液；贝那普利；早期糖尿病肾病

    Observation on effect of combined use of radix astragali injection and benazepril for treatment of early diabetic nephropathy

    Qiao Jing. Department of Nephrology, Zhoupu Hospital, Nanhui District, Shanghai 201318, China

    【Abstract】 Objective This study investigated the effects and mechanisms of the combined use of Radix Astragali injection (RAI) and benazepril for treatment of eearly diabetic nephropathy (DN). Methods Forty patients with early DN were randomly assigned to the control group (n=20) treated by benazepril and the experiment group (n=20) treated by RAI and benazepril. Additionally, the conventional western medication was used by all patients in both groups. Blood pressure, urine albumin excretion rate (UAER), uricβ2-microglobulin (β2-MG), fasting blood glucose (FBG), serum creatinine (SCr), blood urea nitrogen (BUN) and plasma albumin were measured before and after the treatment for all participants and data were collected. Changes of these indexes were compared within and between the two groups.Results There were no significant differences of the baseline data in all these indexes between the experiment group and the control group. After four weeks of the treatment, blood pressure, UAER and uricβ2-MG were significantly lowered in both groups (P<0.05 or P<0.01) and the decreases in the experiment group were more obvious. The FBG, SCr and BUN levels of the experiment group were slightly lower than those of the control group, but the differences between the two groups were not statistically significant (P>0.05).Conclusion Combination of RAI and benazepril with conventional western medication has a better effect on the treatment of early DN than only benazepril with conventional western medication. Its mechanisms are related with decreasing TGF-β1, improving early high renal perfusion and filtration of DN and so on. ......