中药联合达格列净治疗早期糖尿病肾病的临床效果观察

Clinical Effect Observation of Chinese Medicine Combined with Dapagliflozin in Treatment of Early Diabetic Nephropathy

目的:观察中药联合达格列净治疗早期糖尿病肾病的临床效果。方法:选取2022年1月—2023年3月甘肃省第二人民医院收治的早期糖尿病肾病患者86例为观察对象,根据随机数字表法分为对照组(采用达格列净治疗)和观察组(采用中药联合达格列净治疗),各43例。比较两组患者血糖指标、中医症状积分、不良反应发生率、肾功能指标、治疗效果。结果:治疗后,观察组空腹血糖、餐后2 h血糖、糖化血红蛋白水平低于对照组,差异有统计学意义(P<0.001)。观察组乏力、恶心呕吐、头晕、夜尿多、水肿、纳差积分低于对照组,差异有统计学意义(P<0.001)。观察组不良反应发生率低于对照组,差异有统计学意义(P=0.035)。治疗后,观察组24 h尿蛋白定量、血肌酐、尿素氮水平低于对照组,血清白蛋白水平高于对照组,差异有统计学意义(P<0.001)。观察组治疗总有效率高于对照组,差异有统计学意义(P=0.044)。结论:中药联合达格列净治疗早期糖尿病肾病患者的效果显著,可改善临床症状及血糖指标、肾功能,安全性高。

Objective:To observe the clinical effect of Chinese medicine combined with dapagliflozin in treatment of early diabetic nephropathy.Methods:A total of 86 patients with early diabetic nephropathy admitted to the Second People's Hospital of Gansu Province from January 2022 to March 2023 were selected as the study subjects.According to random number table method,they were divided into control group(dapagliflozin treatment)and observation group(Chinese medicine combined with dapagliflozin treatment),with 43 cases in each group.The blood glucose indexes,TCM symptom scores,incidence of adverse reactions,renal function indexes and treatment effects in the two groups were compared.Results:After treatment,the fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin levels in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.001).The scores of fatigue,nausea and vomiting,dizziness,nocturia,edema,and anorexia in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.001).The incidence of adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(P=0.035).After treatment,the 24 h urine protein quantification,serum creatinine and urea nitrogen levels in the observation group were lower than those in the control group,and the serum albumin levels in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.001).The overall effective rate of treatment in the observation group was higher than that in the control group,and the difference was statistically significant(P=0.044).Conclusion:The Chinese medicine combined with dapagliflozin has a significant effect in the treatment of patients with early diabetic nephropathy,which can improve clinical symptoms,blood glucose indexes and renal function,with a high safety.