在2型糖尿病和慢性病中添加阿斯特拉:一个多中心,评估者盲,随机对照试验
Kam Wa Chan1, Alfred Siu Kei Kwong2, Pun Nang Tsui3
1Division of Nephrology, Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
概括
在患有慢性病 (CKD) 的糖尿病患者中,阿斯特拉加勒斯补充剂减缓了功能下降. 在临床试验中,这种草药在48周内对脏健康产生保护作用.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 药理学 药理学是指药理学的学科.
- 综合医学是一个整体的医学.
背景情况:
- 糖尿病是慢性病 (CKD) 和末期病的主要原因.
- 有限的长期前性数据存在于Astragalus的脏保护作用,这是一个传统的草药.
- 这项研究研究了阿斯特拉加勒斯在糖尿病慢性病患者中保持功能方面的有效性.
研究的目的:
- 评估口服阿斯特拉加勒斯颗粒作为标准护理的附加疗法的有效性.
- 评估阿斯特拉加勒斯对估计膜过率 (eGFR) 和尿中白蛋白与肌素比率 (UACR) 的下降的影响.
- 为了确定阿斯特拉加勒斯在2型糖尿病,2-3期慢性瘤和宏相蛋白尿症患者的安全性和有效性.
主要方法:
- 一个为期48周的,随机的,评估者盲目的,标准护理控制的多中心临床试验.
- 118名EGFR 30-90毫升/分钟/1.73米2和UACR 300-5000毫克/克的患者被分配给仅接受阿斯特拉加勒斯颗粒或标准护理.
- 主要结局包括eGFR和UACR变化的斜率;次要结局包括血压和不良事件.
主要成果:
- 与单独的标准护理相比,阿斯特拉加勒斯治疗导致eGFR下降的速度显著减慢 (4.6毫升/分钟/1.73m2/年) (p=0.003).
- 两组之间UACR变化的斜率没有显著差异 (p=0.392).
- 阿斯特拉加勒斯补充疗法导致系统性血压显著降低 (7.9 mmHg,p=0.003),并且耐受良好.
结论:
- 在患有2型糖尿病,2-3期慢性瘤和大蛋白尿症的患者中,为期48周的阿斯特拉加勒斯补充治疗显著稳定了功能.
- 阿斯特拉加卢斯显示出作为减缓糖尿病患者CKD进展的辅助治疗的潜力.
- 进一步的研究可能会探索在治疗糖尿病病及其相关并发症方面的作用.
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