Shi Ruifeng, Wang Yanping, An Xiaofei, Ma Jianhua, Wu Tongzhi, Yu Xiaojin, Liu Su, Huang Liji, Wang Lijuan, Liu Jingshun, Ge Jing, Qiu Shanhu, Yin Han, Wang Xiaolai, Wang Yao, Yang Bingquan, Yu Jiangyi, Sun Zilin
Department of Endocrinology, Zhongda Hospital, School of Medicine, Institute of Diabetes, Southeast University, Nanjing, China.
Department of Endocrinology, Wuxi Third People's Hospital, Wuxi, China.
Front Endocrinol (Lausanne). 2019 Feb 22;10:100. doi: 10.3389/fendo.2019.00100. eCollection 2019.
We investigated the effects of Traditional Chinese Medicine (TCM) on the occurrence and progression of albuminuria in patients with type 2 diabetes. In this randomized, double-blind, multicenter, controlled trial, we enrolled 600 type 2 diabetes without diabetic nephropathy (DN) or with early-stage DN. Patients were randomly assigned (1:1) to receive Liuwei Dihuang Pills (LWDH) (1.5 g daily) and Ginkgo biloba Tablets (24 mg daily) orally or matching placebos for 24 months. The primary endpoint was the change in urinary albumin/creatinine ratio (UACR) from baseline to 24 months. There were 431 patients having UACR data at baseline and 24 months following-up in both groups. Changes of UACR from baseline to follow-up were not affected in both groups: -1.61(-10.24, 7.17) mg/g in the TCM group and -0.73(-7.47, 6.75) mg/g in the control group. For patients with UACR ≥30 mg/g at baseline, LWDH and Ginkgo biloba significantly reduced the UACR value at 24 months [46.21(34.96, 58.96) vs. 20.78(9.62, 38.85), < 0.05]. Moreover, the change of UACR from baseline to follow-up in the TCM group was significant higher than that in the control group [-25.50(-42.30, -9.56] vs. -20.61(-36.79, 4.31), < 0.05]. LWDH and Ginkgo biloba may attenuate deterioration of albuminuria in type 2 diabetes patients. These results suggest that TCM is a promising option of renoprotective agents for early stage of DN. The study was registered in the Chinese Clinical Trial Registry. (no. ChiCTR-TRC-07000037, chictr.org).
我们研究了中药对2型糖尿病患者蛋白尿发生及进展的影响。在这项随机、双盲、多中心对照试验中,我们纳入了600例无糖尿病肾病(DN)或处于早期DN阶段的2型糖尿病患者。患者被随机分配(1:1)口服六味地黄丸(LWDH)(每日1.5克)和银杏叶片(每日24毫克)或相应安慰剂,为期24个月。主要终点是从基线到24个月时尿白蛋白/肌酐比值(UACR)的变化。两组均有431例患者在基线和24个月随访时有UACR数据。两组从基线到随访时UACR的变化均未受影响:中药组为-1.61(-10.24,7.17)mg/g,对照组为-0.73(-7.47,6.75)mg/g。对于基线时UACR≥30mg/g的患者,六味地黄丸和银杏叶片在24个月时显著降低了UACR值[46.21(34.96,58.96)对20.78(9.62,38.85),<0.05]。此外,中药组从基线到随访时UACR的变化显著高于对照组[-25.50(-42.30,-9.56)对-20.61(-36.79,4.31),<0.05]。六味地黄丸和银杏叶片可能减轻2型糖尿病患者蛋白尿的恶化。这些结果表明,中药是早期DN肾保护药物的一个有前景的选择。该研究已在中国临床试验注册中心注册。(编号:ChiCTR-TRC-07000037,chictr.org)