Observational Study on the Efficacy of Spironolactone Combined with Valsartan in the Treatment of Early Diabetic Nephropathy
Objective To explore the intervention value of spironolactone and valsartan combined application in patients with early diabetic nephropathy.Methods 62 patients treated in The Second People's Hospital of Xinxiang from August 2021 to February 2023 were selected as the research subjects.According to the random number table method,they were divided into the control group(single treatment with valsartan)and the experimental group(combined treatment with spironolactone and valsartan),each with 31 cases.Both groups were treated continuously for 6 months.The treatment effects of the two groups were compared,as well as the renal function indicators[glomerular filtration rate(eGFR),urine albumin/creatinine ratio(UACR)],serum potassium level,blood glucose(fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin)and blood pressure level(systolic and diastolic pressure),hemorheology indicators(fibrinogen,plasma viscosity,and hematocrit),and adverse reactions(nausea and vomiting,dizziness and headache,and hypotension)before and after treatment.Results The effective rate of treatment in the experimental group(96.77%)was higher than that in the control group(80.65%),and the difference was statistically significant(P＜0.05).Before treatment,there was no statistical significance in the comparison of renal function indicators and serum potassium level between the two groups(P＞0.05).After treatment,the UACR level of both groups decreased,and the eGFR and serum potassium level increased,with a statistically significant difference(P＜0.05).The UACR level in the experimental group was lower than that in the control group,and the eGFR and serum potassium level were higher than those in the control group,with a statistically significant difference(P＜0.05).Before treatment,there was no statistical significance in the comparison of fasting blood glucose,2-hour postprandial blood glucose,glycated hemoglobin,systolic and diastolic pressure between the two groups(P＞0.05).After treatment,the levels of fasting blood glucose,2-hour postprandial blood glucose,glycated hemoglobin,systolic and diastolic pressure in both groups showed a downward trend,and all indicators in the experimental group were lower than those in the control group,with a statistically significant difference(P＜0.05).Before treatment,there was no statistical significance in the comparison of hemorheology indicators between the two groups(P＞0.05).After treatment,the levels of fibrinogen,plasma viscosity,and hematocrit in both groups showed a downward trend,and all indicators in the experimental group were lower than those in the control group,with a statistically significant difference(P＜0.05).The incidence of adverse reactions in the experimental group(16.13%)was compared with the control group(6.45%),and the difference was not statistically significant(P＞0.05).Conclusion The combined treatment of spironolactone and valsartan in patients with early diabetic nephropathy can effectively improve the treatment effect,improve renal function,serum potassium,blood glucose,blood pressure,and hemorheology indicator levels,and is safe and reliable,worthy of clinical application.
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