摘要
目的:观察益肾化湿颗粒联合达格列净治疗糖尿病肾病(DN)脾肾气虚证的临床疗效及对血小板反应蛋白1 (TSP-1)、可溶性Axl受体酪氨酸激酶(sAxl)水平的影响。方法:采用随机数字表法将88例DN脾肾气虚证患者分为对照组与观察组各44例。对照组给予单纯达格列净治疗,观察组给予益肾化湿颗粒联合达格列净治疗。比较2组治疗前后中医证候积分、肾脏功能指标、血糖指标、TSP-1、sAxl水平,评估2组临床疗效及不良反应发生情况。结果:治疗后,观察组总有效率93.18%,高于对照组77.27%(P<0.05)。治疗后,2组中医证候积分、尿白蛋白/肌酐比值(UACR)、尿白蛋白排泄率(UAER)、空腹血糖(FBG)、餐后2 h血糖(P2hBG)、糖化血红蛋白(HbA1c)、 TSP-1、 sAxl水平均低于治疗前(P<0.05),肾小球滤过率(eGFR)水平高于治疗前(P<0.05),且观察组治疗后UACR、UAER、TSP-1、sAxl水平及血糖指标均低于对照组(P<0.05),eGFR水平高于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:益肾化湿颗粒联合达格列净治疗DN脾肾气虚证疗效显著,能有效改善患者肾脏功能,控制血糖,降低TSP-1、sAxl水平,安全性较高。
Objective:To observe the clinical effect of the therapy of Yishen Huashi Granules combined with Dapagliflozin on diabetic nephropathy(DN)with spleen-kidney qi deficiency syndrome and its effects on the levels of thrombospondin-1(TsP-1)and soluble Axl receptor tyrosine kinase(sAxl).Methods:A total of 88 DN patients with spleen-kidney qi deficiency syndrome were divided into the control group and the observation group according to the random number table method,with 44 cases in each group.The control group was given Dapagliflozin for treatment,and the observation group was treated with Yishen Huashi Granules combined with Dapagliflozin.The traditional Chinese medicine(TCM)syndrome scores,levels of kidney function indexes,blood sugar indexes,and levels of TSP-1 and sAxl were compared between the two groups:the clinical effects and the incidence of adverse reactions in the two groups were evaluated.Results:After treatment,the total effective rate was 93.18%in the observation group,higher than that of 77.27%in the control group(P<0.05).After treatment,the TCM syndrome scores,and the levels of urine albumin creatinine ratio(UACR),urinary albumin excretion rate(UAER),fasting blood glucose(FBG),2-hour postprandial glucose(P2hBG)and hemoglobin A1c(HbA1c),TSP-1 and sAxl in the two groups were lower than those before treatment(P<0.05),and the estimated glomerular filtration rate(eGFR)levels were higher than those before treatment(P<0.05);the levels of UACR,UAER,TSP-1,sAxl and blood sugar indexes in the observation group were lower than those in the control group(P<0.05),and the eGFR level was higher than that in the control group(P<0.05).There Was no significant difference being found in the comparison of incidence of adverse reactions between the two groups(P>O.05).Conclusion:The therapy of Yishen Huashi Granules combined with Dapagliflozin has a significant curative effect on DN with spleen-kidney qi deficiency syndrome,which can effectively improve the kidney function of patients,control the blood sugar and decrease the levels of TSP-1 and sAxl with great safety.
作者
张瑞霞
左来孟
宋琼
ZHANG Ruixia;ZUO Laimeng;SONG Qiong(Department of Nephrology and Rheumatology,Xinxiang First People's Hospital,Xinxiang Henan 453000,China)
出处
《新中医》
CAS
2024年第5期90-94,共5页
New Chinese Medicine
