卡格列净联合阿魏酸哌嗪片对糖尿病肾病患者肾功能、血糖及血清胰岛素样生长因子1影响的随机对照研究

A randomized controlled study on effect of canagliflozin combined with piperazineferulate tablets on renal function,blood glucose and serum insulin-like growthfactor 1 in patient with diabetic nephropathy

目的 探讨卡格列净联合阿魏酸哌嗪片在糖尿病肾病(DN)治疗中的应用效果。方法 在2021年6月至2022年12月西安国际医学中心医院、陕西省康复医院收治的DN患者中,随机选取82例作为研究对象。按照随机数字表法将82例DN患者分为对照组、观察组,开展单盲研究,每组41例。所有患者均给予常规降糖治疗,在此基础上对照组给予阿魏酸哌嗪片治疗,观察组则行卡格列净联合阿魏酸哌嗪片治疗。评估并比较两组临床疗效,同时观察血糖、肾功能、血清炎症因子以及胰岛素样生长因子1(IGF-1)等指标水平变化。结果 治疗后,观察组总有效率(90.24%)高于对照组(73.17%),差异有统计学意义(P<0.05);治疗后观察组患者空腹血糖、餐后2 h血糖、糖化血红蛋白、血肌酐、血尿素氮、24 h尿蛋白定量、白细胞介素-6、肿瘤坏死因子-α及IGF-1水平均低于对照组,差异均有统计学意义(P<0.05)。结论 卡格列净联合阿魏酸哌嗪片治疗DN,可进一步控制患者血糖和IGF-1水平、改善肾功能与炎症状态,继而提升临床治疗效果。

Objective To investigate the application effect of canagliflozin combined with piperazine ferulate tablets in the treatment of diabetic nephropathy(DN).Methods Eighty-two patients with DN conforming to the study condition admitted and treated in Xi′an International Medical Center Hospital and Shaanxi Provincial Rehabilitation Hospital from June 2021 to December 2022 were randomly selected as the study subjects and divided into the control group and observation group by the random number table method to conduct the single-blind study,41 cases in each group.All patients were treated with the routine hypoglycemic therapy,on this basis the control group was given piperazine ferulate tablet,while the observation group was treated with canagliflozin combined with piperazine ferulate tablets.The clinical effects were evaluated and compared between the two groups,meanwhile the changes of blood glucose,kidney function,serum inflammatory factor and insulin-like growth factor 1(IGF-1)levels were observed.Results After treatment,the total effective rate in the observation group was 90.24%,which was higher than 73.17%in the control group,and the difference was statistically significant(P<0.05);after treatment,the levels of fasting blood glucose,2 h postprandial blood glucose,glycosylated hemoglobin,blood creatinine,blood urea nitrogen,24 h urine protein quantification,interleukin 6,tumor necrosis factorαand IGF-1 in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Canagliflozin combined with piperazine ferulate tablets in treating DN can further control the patients′blood glucose and IGF-1 levels,improve the renal function and inflammation status,then subsequently enhance the clinical effects.