Efficacy and Safety of Valsartan Amlodipine Tablets Combined with Alpha-lipoic Acid in the Treatment of Elderly Patients with Type 2 Diabetic Nephropathy Complicated with Hypertension
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摘要:
目的 应用缬沙坦氨氯地平片联合α-硫辛酸治疗老年2型糖尿病肾病合并高血压的疗效及治疗安全性分析。 方法 选取2018年2月至2019年8月中国医科大学附属第一医院收治的老年2型糖尿病肾病合并高血压患者40例,采用配对法,分为对照组(n = 20),男13例,女7例,平均年龄(64.24±1.16)岁。观察组(n = 20),男11例,女9例,平均年龄(65.12±1.12)岁。2组患者均接受常规降血糖治疗。对照组采用缬沙坦氨氯地平片进行治疗;观察组采用缬沙坦氨氯地平片联合α-硫辛酸进行治疗。对观察组及对照组在治疗前后舒张压(diastolic blood pressure,DBP)、收缩压(systolic blood pressure,SBP)、尿白蛋白排泄率(urinary albumin excretion rate,UAER)、尿素氮(blood urea nitrogen,BUN)、血肌酐(serum creatinine,SCr)以及不良反应情况进行对比。 结果 观察组的SBP、DBP、UAER以及不良反应均低于对照组,其治疗效果及安全性优于用对照组,差异有统计学意义(P < 0.05)。 结论 缬沙坦氨氯地平片联合α-硫辛酸治疗老年2型糖尿病肾病合并高血压的效果良好、稳定性佳、安全性更显著,患者满意度较高,可在临床推广应用。 -
关键词:
- 老年2型糖尿病肾病合并高血压 /
- 缬沙坦氨氯地平片 /
- α-硫辛酸 /
- 治疗效果
Abstract:Objective To analyze the clinical efficacy and safety of valsartan amlodipine tablets combined with alpha-lipoic acid in the treatment of elderly type 2 diabetic nephropathy complicated with hypertension. Methods A total of 40 elderly patients with type 2 diabetic nephropathy complicated with hypertension who were admitted to the First Affiliated Hospital of China Medical University from February 2018 to August 2019 were enrolled in this study. They were divided into control group and observation group by pairing method. In the control group (n = 20), there were 13 males and 7 females with an average age of (64.24±1.16). In the observation group (n = 20), there were 11 males and 9 females with an average age of (65.12±1.12). Patients in both groups received routine hypoglycemic therapy, the control group was treated with valsartan and amlodipine tablets, and the observation group was treated with valsartan and amlodipine tablets combined with α-lipoic acid. Diastolic blood pressure (DBP), systolic blood pressure (SBP), Urinary albumin excretion rate (UAER), blood nitrogen (BUN), serum creatinine (SCR) and adverse reactions were compared between the observation group and the control group before and after treatment. Results The SBP, DBP, UAER and adverse reactions in the observation group were lower than those in the control group, and the efficacy and safety of the treatment were better than those in the control group with single drug (valsartan amlodipine tablet), the difference was statistically significant (P < 0.05). Conclusion Compared with valsartan amlodipine tablets alone, valsartan amlodipine tablets have better therapeutic effect, more stable, better safety and better patient satisfaction degree after two months of treatment, which is worthy of to long-term clinical application and promotion. -
表 1 2组血压、UAER、BUN、SCr比较( $\bar x \pm s $)
Table 1. Comparison of blood pressure,UAER,bun and SCR between the two groups ( $\bar x \pm s $)
组别 n SBP(mm Hg) DBP(mm Hg) SCr(μg/L) BUN(mmol/L) UAER(μg/min) 对照组 20 治疗前 158.21 ± 8.34 102.23 ± 5.43 68.26 ± 9.23 5.26 ± 0.23 143.26 ± 26.28 治疗后 143.12 ± 6.32a 98.26 ± 4.23﹡ 63.26 ± 8.23﹡ 4.12 ± 0.21﹡ 133.22 ± 25.13﹡ 观察组 20 治疗前 159.11 ± 8.45 101.14 ± 5.13 69.22 ± 9.78 5.34 ± 0.41 144.26 ± 28.13 治疗后 134.13 ± 5.3# 92.22 ± 4.2# 51.16 ± 7.2# 3.36 ± 0.42# 103.26 ± 16.2# 与治疗前比较,﹡P < 0.05;与对照组比较, #P < 0.05。 表 2 2组病例治疗效果比较[n(%)]
Table 2. Comparison of therapeutic effect between the two groups[n (%)]
组别 n 显效 有效 无效 总有效率 对照组 20 4 10 6 14(70) 观察组 20 6 12 2 18(90)* 与对照组相比较,*P < 0.05。 表 3 2组病例不良反应发生率比较
Table 3. Comparison of the incidence of adverse reactions between the two groups
组别 n 头晕 嗜睡 腹泻 不良反应发生率(%) 对照组 20 2 2 1 25 观察组 20 1 1 0 10* χ2 − − − − 5.0 P − − − − < 0.05 与对照组相比,*P < 0.05。 -
[1] Felício J S,De Souza A C,Kohlmann N,et al. Clinical efficacy of nifedipine controlled release tablet and valsartan in the treatment of type 2 diabetic nephropathy and hypertension of elderly patients[J]. Chin General Pract,2012,15(7C):2439-2441. [2] 张静. 探讨厄贝沙坦与钙离子拮抗剂联合用于老年2型糖尿病肾病合并高血压的治疗效果[J]. 中国现代药物应用,2017,11(22):97-98. [3] 黄超岚. 卡托普利联合硝苯地平治疗原发性高血压合并2型糖尿病尿微量白蛋白的临床观察[J]. 中国药房,2018,22(16):1470-1472. [4] 王芹. 氯沙坦联合硝苯地平对老年2型糖尿病肾病合并高血压患者肾功能的影响[J]. 中国药业,2016,21(8):38-39. [5] 罗天惠,段正素. 老年2型糖尿病肾病合并高血压厄贝沙坦与钙离子拮抗剂联合应用的治疗效果及对肾功能的保护作用[J]. 心理医生,2017,23(6):12-13. [6] 潘佳秋,王慧慧,张超,等. 新诊断2型糖尿病患者血清视黄醇结合蛋白4和游离脂肪酸水平变化及其与胰岛素敏感性的关系研究[J]. 中国全科医学,2017,14(21):2370-2372. [7] 王东娜,王旭梅. 厄贝沙坦联合钙离子拮抗剂治疗老年2型糖尿病肾病合并高血压的效果分析[J]. 中国实用医药,2019,14(21):101-102. [8] 艾冠男,王兆丰,杨晓旭,等. 老年高血压前期患者临床特点及高盐饮食对其预后影响[J]. 临床军医,2019,7(5):466-471. [9] 郭玫. 不同性别老年人2型糖尿病患者的生活质量及影响因素[J]. 中国老年学,2020,12(23):5106-5111. [10] 丁少玉,鞠昌萍. 进餐顺序在糖尿病病人饮食治疗中的进展研究[J]. 护理研究,2020,12(23):4199-4202. doi: 10.12102/j.issn.1009-6493.2020.23.017 [11] 夏碧荣,公振宇. 缬沙坦联合氨氯地平与缬沙坦联合氢氯噻嗪治疗老年高血压患者的效果研究[J]. 中国社区医师,2021,37(9):61-62. doi: 10.3969/j.issn.1007-614x.2021.09.030 [12] 孔庆琳. 缬沙坦联合福辛普利钠与氨氯地平治疗高血压合并轻度认知功能障碍的疗效观察[J]. 当代医学,2021,27(9):128-130. doi: 10.3969/j.issn.1009-4393.2021.09.049 [13] 向会,傅明强,周巍. 缬沙坦氨氯地平片联合辛伐他汀治疗老年高血压合并血脂异常患者的疗效及血清学变化分析[J]. 中国现代医生,2021,59(5):125-128. [14] 张红娥,王树鲜. 缬沙坦与氨氯地平联合治疗社区老年原发性高血压合并糖尿病患者的临床效果研究[J]. 中国实用医药,2021,16(2):19-21. [15] 何晓玮,钟涛. α硫辛酸辅助奥美沙坦酯对糖尿病肾病患者血清miR-150-5p及miR-155-5p表达的影响[J]. 中国现代应用药学,2021,38(5):624-629.