肾衰宁片联合卡格列净片治疗早期糖尿病肾病临床研究

Clinical Study on Shenshuaining Tablets Combined with Canagliflozin Tablets for Early Diabetic Nephropathy

目的:观察肾衰宁片联合卡格列净片治疗早期糖尿病肾病的临床疗效。方法:将104例早期糖尿病肾病气阴两虚兼痰瘀证患者随机分为对照组和观察组各52例。2组患者均服用卡格列净片,根据情况加用其他口服降糖药或胰岛素,调整生活方式,控制血脂等危险因素。观察组加予肾衰宁片治疗。2组均连续观察16周。治疗前后检测尿白蛋白排泄率(UAER)、尿微量白蛋白与肌酐的比值(ACR)、β2微球蛋白(β2-MG)、血胱抑素C (CysC)、空腹血糖(FBG)、餐后2 h血糖(P2hBG)、糖化血红蛋白(HbA1c)水平,统计血糖指标的达标情况;评定中医证候评分,比较2组的疗效。结果:治疗后,观察组的临床疗效与中医证候疗效均优于对照组(P<0.05)。2组ACR、UAER、β2-MG及CysC水平均较治疗前降低(P<0.01),观察组ACR、UAER、β2-MG及CysC水平均低于对照组(P<0.01)。观察组HbA1c达标率高于对照组(P<0.01)。结论:应用肾衰宁片联合卡格列净片治疗早期糖尿病肾病气阴两虚兼痰瘀证患者,可更好地控制血糖,减轻早期肾损害。

Objective:To observe the clinical effect of Shenshuaining tablets combined with Canagliflozin tablets on early diabetic nephropathy. Methods: A total of 104 patients with early diabetic nephropathy of qi and yin deficiency syndrome complicated with phlegm-stasis syndrome were randomly divided into the control group and the observation group,52 cases in each group. Both groups were treated with Canagliflozin tablets,and other oral hypoglycemic drugs or insulin according to different situation,to adjust their lifestyle,control blood lipid and other risk factors. The observation group was additionally treated with Shenshuaining tablets. Both groups were observed for 16 weeks. The levels of urinary albumin excretion rate(UAER),albumin/creatinine ratio(ACR),β2 microglobulin(β2-MG),cystatin C(CysC),fasting blood glucose(FBG),2-hour postmeal blood glucose(P2 hBG),and hemoglobin A1 c(HbA1 c) were measured before and after treatment,and the standard status of blood glucose indexes was counted. The Chinese medicine syndrome score and the therapeutic effect in the two groups were evaluated and compared. Results: After treatment, the clinical effect and therapeutic effect of Chinese medicine syndrome in the observation group were better than those in the control group(P<0.05). The levels of ACR,UAER,β2-MG and CysC in both groups were all decreased when compared with those before treatment(P<0.01),and the above levels in the observation group were lower than those in the control group(P<0.01). The attainment rate of HbA1 c in the observation group was higher than that in the control group(P<0.01). Conclusion: The therapy of Shenshuaining tablets combined with Canagliflozin tablets for patients with early diabetic nephropathy of qi and yin deficiency syndrome complicated with phlegm-stasis syndrome,can better control blood glucose and reduce early kidney damage.