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Objective@#To analyze the delayed effect of candesartan ester combined with tripterygium wilfordii on renal failure of chronic kidney disease (CKD) from 2 to 3.@*Methods@#From May 2015 to May 2016, 80 patients with chronic renal insufficiency (CRF) in Jiaxing Hospital of Zhejiang Provincial Armed Police Corps were selected in the research.The patients were randomly divided into the combined group and control group by compute random grouping method, with 40 cases in each group.The combined group was given candesartan ester combined with tripterygium wilfordii glycosides, and the control group was given glucocorticoid treatment.The therapeutic effect, the incidence of adverse reactions, improvement of clinical indicators and degree of kidney damage were compared between the two groups.@*Results@#The total effective rate of the combined group was 95%, which was higher than 80% of the control group (χ2=4.116, P<0.05). The incidence of adverse reactions in the combined group was 7.5%, which was significantly lower than that in the control group (χ2=6.657, P<0.05). The biochemical parameters of the two groups had no statistically significant differences(t=1.032, 0.835, 1.017, 0.924, all P>0.05), but the serum urea nitrogen (BUN), serum creatinine (Scr), glomerular filtration rate (GFR) and uric acid levels in the combined group were (6.3±1.2)mmol/L, (99.6±4.5)μmol/L, (82.7±6.5)mL/min and (335.2±28.6)μmol/L, respectively, which were significantly better than those of the control group[(7.9±2.5)mmol/L, (128.9±6.4)moL/L, (59.6±7.3)mL/min and (437.9±37.1)mol/L](t=7.812, 8.119, 7.523, 8.981, all P<0.05). Before treatment, the renal damage degree between the two groups had no statistically significant difference (P>0.05). After treatment, the proportions of renal damage degree stage Ⅰ, Ⅱ, Ⅲ and Ⅳ in the combined group were 72.5%, 12.5%, 15.0% and 0.00%, respectively, which were significantly lower than those in the control group (22.5%, 32.5%, 37.5% and 7.5%) (χ2=20.058, 4.592, 5.237, 1.394, all P<0.05).@*Conclusion@#Candesartan ester combined with tripterygium wilfordii can be effectively used in the treatment of CKD at 2 to 3 stages, and the incidence of adverse reactions of drugs is relatively low, which can effectively improve the clinical indicators of patients and has a good retarding effect on renal failure.Therefore, it is recommended to be widely used in clinical treatment.
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Objective To analyze the delayed effect of candesartan ester combined with tripterygium wilfordii on renal failure of chronic kidney disease (CKD) from 2 to 3.Methods From May 2015 to May 2016,80 patients with chronic renal insufficiency (CRF) in Jiaxing Hospital of Zhejiang Provincial Armed Police Corps were selected in the research.The patients were randomly divided into the combined group and control group by compute random grouping method,with 40 cases in each group.The combined group was given candesartan ester combined with tripterygium wilfordii glycosides,and the control group was given glucocorticoid treatment.The therapeutic effect,the incidence of adverse reactions,improvement of clinical indicators and degree of kidney damage were compared between the two groups.Results The total effective rate of the combined group was 95%,which was higher than 80% of the control group (χ2 ＝4.116,P＜0.05).The incidence of adverse reactions in the combined group was 7.5%,which was significantly lower than that in the control group ( χ2 ＝6.657,P＜0.05).The biochemical parameters of the two groups had no statistically significant differences (t＝1.032,0.835,1.017,0.924,all P＞0.05),but the serum urea nitrogen (BUN),serum creatinine (Scr),glomerular filtration rate (GFR) and uric acid levels in the combined group were (6.3 ±1.2)mmol／L,(99.6 ±4.5)μmol／L,(82.7 ±6.5)mL／min and (335.2 ±28.6)μmol／L,respectively, which were significantly better than those of the control group [(7.9 ±2.5)mmol／L,(128.9 ±6.4)moL／L,(59.6 ± 7.3)mL／min and (437.9 ±37.1) mol／L] ( t＝7.812,8.119,7.523,8.981,all P＜0.05).Before treatment,the renal damage degree between the two groups had no statistically significant difference (P＞0.05).After treatment,the proportions of renal damage degree stage Ⅰ,Ⅱ,ⅢandⅣin the combined group were 72.5%,12.5%,15.0%and 0.00%,respectively,which were significantly lower than those in the control group (22.5%,32.5%,37.5% and 7.5%) (χ2＝20.058,4.592,5.237,1.394,all P＜0.05).Conclusion Candesartan ester combined with tripterygium wilfordii can be effectively used in the treatment of CKD at 2 to 3 stages,and the incidence of adverse reactions of drugs is relatively low,which can effectively improve the clinical indicators of patients and has a good retarding effect on renal failure.Therefore,it is recommended to be widely used in clinical treatment.
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Objective To investigate the clinical efficacy of tripterygium wilfordii in the treatment of early diabetic nephropathy and its mechanism .Methods 86 patients with early diabetic nephropathy admitted to Jiaxing Hospital of Zhejiang Provincial Armed Police Corps from December 2015 to December 2017 were selected as research subjects.They were randomly divided into two groups according to the digital table ,with 43 cases in each group .The control group was treated by conventional internal medicine , while the observation group was added tripterygium glycosides on the basis of the control group .The clinical efficacy of the two groups and the changes of serum matrix metalloproteinase-9 (MMP-9) and plasminogen activator -1 (PAI-1) before and after treatment were compared . Results The total effective rate of the observation group was significantly higher than that of the control group (86.04％vs.58.14％)(χ2 =8.323,P=0.004).The MMP-9 and PAI-1 levels and urinary protein of the two groups after treatment were significantly improved ,but the changes of the observation group [ ( 57 .36 ±10 .24 ) ng/L, (24.39 ±7.66)ng/mL,(70.35 ±12.58)μg/min] were more significant than those of the control group [(85.62 ± 15.42)ng/L,(29.64 ±8.61)ng/mL,(102.57 ±20.36)μg/min](t=10.011,P<0.001;t=2.987,P=0.004;t=3.828,P<0.001).Conclusion The therapeutic effect of tripterygium wilfordii in the treatment of early diabetic nephropathy is significant .The mechanism is related to improving the expression of MMP -9 in kidney tissue and reducing the level of PAI-1.
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Objective To observe the clinical curative effect of tripterygium polyglycoside combined with cozaar in elderly patients with IgA nephropathy (IgAN) and its influence on expressions of TGF-β1,PAI-1 and VEGF.Methods Eighty elderly patients with IgA nephropathy in Jiaxing Hospital of Armed Police Zhejiang Corps from April 2011 to January 2016 were selected and randomly divided into the control group and observation group,40 cases in each group.The two groups received the routine treatment of chronic basic diseases and took oral cozaar.On this basis the observation group took tripterygium polyglycoside for continuous 12 months.Urine protein,serum creatinine (Scr),blood urea nitrogen (BUN),plasma Alb,urine TGF-β1,PAI-1 and VEGF levels before treatment and at 3,6,12 months after treatment were compared between the two groups.The occurrence situation of adverse reactions was recorded.Results The 24 h urinary protein levels at 3,6,12 months after treatment in the two groups were decreased,moreover the 24 h urine protein level at each time point in the observation group was lower than that in the control group,the difference was statistically significant (P<0.05).The levels of Scr,BUN,urine TGF-β1,PAI-1 and VEGF after treatment in the two groups were decreased compared with before treatment,while the Alb level was increased compared with before treatment,moreover the levels of Scr,BUN,urine TGF-β1,PAI-1 and VEGF in the observation group were lower than those in the control group,while the Alb level was higher than that in the control group,the difference was statistically significant (P<0.05).The observation group appeared 2 cases of leukopenia,1 case of liver dysfunction and no serious adverse reactions occurred.Conclusion Tripterygium polyglycoside combined with cozaar has a significant therapeutic effect on elderly patients with IgAN,can significantly reduce urinary protein and protect renal function,moreover its clinical use is safer.Its efficacy may be related to reducing the expression levels of TGF-β1,PAI-1 and VEGF.