益肾化湿颗粒联合达格列净治疗糖尿病肾病临床观察

The Clinical Effect of Yishen Huashi Granules Combined with Dapagliflozin and Its Influence on Quality of Life of Diabetic Nephropathy

目的研究益肾化湿颗粒联合达格列净治疗糖尿病肾病(DN)的临床疗效及对生存质量的影响。方法将70例DN患者随机分为对照组和观察组,每组35例。对照组予DN一体化治疗方案及达格列净口服治疗,观察组在对照组治疗基础上加用益肾化湿颗粒治疗,共12周,观察2组干预前后临床疗效及生存质量。结果观察组总有效率优于对照组(P<0.05);与对照组相比,观察组降低尿UAER、α1-MG、β2-MG更显著(P<0.05);血ALB上升程度更显著(P<0.05),血BUN、Scr、CysC下降幅度更显著(P<0.05),eGFR上升幅度更显著(P<0.05),提高SOD及降低ROS、AOPPs更显著(P<0.05),降低TG、TC、LDL及提高HDL更显著(P<0.05);提高SF-36、CSSD70评分更显著(P<0.05)。结论益肾化湿颗粒联合达格列净可有效提高DN患者临床疗效,改善患者肾功能、减少蛋白尿、改善氧化应激反应、改善脂质代谢并可提高患者生存质量。

Objective To study the clinical efficacy of Yishen Huashi granules combined with dapagliflozin in the treatment of diabetic nephropathy and its influence on the quality of life.Methods 70 diabetic nephropathy patients were randomly divided into a control group and an observation group,with 35 cases in each group.The control group was given integrated treatment and dapagliflozin oral treatment,and the observation group was treated with Yishen Huashi granules on the basis of the treatment of the control group.The treatment continued 12 weeks.The clinical efficacy and quality of life indicators of the two groups were observed before and after intervention.Results The total effective rate of the observation group was higher than the total effective rate of the control group.Compared with the control group,the observation group reduced urine UAER,α1-MG,β2-MG more significantly(P<0.05),the observation group.The blood ALB increased significantly(P<0.05).Compared with the control group,the blood BUN,Scr,CysC decreased significantly in the observation group(P<0.05),and the eGFR increased significantly in the observation group(P<0.05).Compared with the control group,the observation group increased SOD and decreased ROS and AOPPs more significantly(P<0.05).Compared with the control group,the observation group reduced TG,TC,LDL and increased HDL more significantly(P<0.05).Compared with the control group,the observation group improved the scores of SF-36 and CSSD70 more significantly(P<0.05).Conclusion Yishen Huashi Granules combined with dapagliflozin can effectively improve the clinical efficacy of diabetic nephropathy patients,improve renal function,reduce proteinuria,improve oxidative stress response,improve lipid metabolism and improve the quality of life of patients.