补泄理肾汤联合沙格列汀片治疗早期糖尿病肾病的临床观察

Clinical Effect of Buxie Lishen Decoction Combined with Saxagliptin in the Treatment of Early Diabetic Nephropathy

目的探讨补泄理肾汤联合沙格列汀片治疗早期糖尿病肾病的临床疗效。方法选取2018年6月—2020年6月期间三亚市中医院肾病内分泌科收治的早期糖尿病肾病患者120例作为研究对象,按照随机数字表法分为对照组和观察组,每组各60例。对照组口服5 mg沙格列汀片,1次/d。在此基础上观察组口服100 ml补泄理肾汤,2次/d。治疗2个月后,评价两组患者临床疗效和安全性;观察比较两组患者治疗前后血糖指标[空腹血糖(Fasting Plasma Glucose,FPG)、餐后2 h血糖(2-hours postprandial glucose,2 h PG)、糖化血红蛋白(Glycated hemoglobin glycosylated hemoglobin,HbA1C)]、生化指标[血清胱抑素C(Cystatin C,Cys-C)、尿白蛋白排泄率(Urinary albumin ejection rate,UAER)、血尿素氮(Blood urea nitrogen,BUN)]及血清炎性因子[血清白细胞介素-6(Interleukin-6,IL-6)、白细胞介素-18(Interleukin-18,IL-18)、肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)]水平变化。结果治疗后观察组临床总有效率为88.33%(53/60)与对照组68.33%(41/60)比较,差异有统计学意义(P<0.05)。两组患者治疗后HbA1C、FPG、2 h PG、UAER、BUN、Cys-C水平均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组HbA1C、FPG、2 h PG、UAER、BUN、Cys-C水平均较对照组明显降低,差异有统计学意义(P<0.05)。两组患者治疗后血清IL-6、IL-18及TNF-α水平均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组血清IL-6、IL-18及TNF-α水平均较对照组明显降低,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论补泄理肾汤联合沙格列汀治疗DN的疗效显著,能明显改善患者肾功能,减轻炎症反应,安全性可靠,值得临床推广使用。

Objective To investigate the clinical effect of Bushilishen decoction combined with saxagliptin tablet in the treatment of early diabetic nephropathy.Methods A total of 120 patients with early diabetic nephropathy who were admitted to the Department of Nephrology and Endocrinology,Sanya Hospital of Traditional Chinese Medicine from June 2018 to June 2020 were selected as the research objects,and divided into the control group and the observation group according to the random number table method,with 60 cases in each group.The control group was given 5 mg saxagliptin tablets orally,once a day.On this basis,the observation group was given 100 ml Buxie Lishen Decoction orally,twice a day.After 2 months of treatment,the clinical efficacy and safety of the two groups were evaluated;the blood glucose indexes[fasting plasma glucose(FPG),2-hours postprandial glucose(2-hours postprandial glucose,2-hours postprandial glucose,2-hours postprandial glucose,2-hours postprandial glucose,2-hours postprandial PG),glycosylated hemoglobin(Glycated hemoglobin glycosylated hemoglobin,HbA1 C)],biochemical indicators[serum cystatin C(Cys-C),urinary albumin excretion rate(Urinary albumin ejection rate,UAER),blood urea nitrogen(BUN)]and serum inflammatory factors[serum interleukin-6(IL-6),interleukin-18(IL-18),tumor necrosis factor-α(TNF-α)]level changes were compared.Results After treatment,the total clinical effective rate in the observation group was 88.33%(53/60)comparedwith 68.33%(41/60)in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of HbA1 C,FPG,2 h PG,UAER,BUN,and Cys-C in the two groups were significantly lower than those before treatment,and the difference was statistically significant(P<0.05).Compared with the control group,the levels of UAER,BUN and Cys-C were significantly lower,and the difference was statistically significant(P<0.05).The levels of serum IL-6,IL-18 and TNF-αin the two groups after treatment were significantly lower than those before treatment,and the difference was statistically significant(P<0.05).Theαlevel was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Buxie Lishen Decoction combined with saxagliptin has significant efficacy in the treatment of DN,can significantly improve the renal function of patients,reduce inflammatory reaction,safe and reliable,which is worthy of clinical promotion.