达格列净联合雷公藤治疗早期2型糖尿病肾病的临床效果观察

Observation on clinical effect of dapagliflozin combined with tripterygium wilfordii in the treatment of early type 2 diabetic nephropathy

目的 研究达格列净联合雷公藤治疗早期2型糖尿病肾病患者的临床疗效。方法 74例早期2型糖尿病肾病患者,按照随机数字表法分为观察组和对照组,各37例。对照组患者通过雷公藤进行治疗,观察组患者在对照组基础上联合达格列净进行治疗。比较两组临床治疗总有效率、血清肾纤维化指标、免疫功能、肾功能指标。比较两组临床治疗总有效率、血清肾纤维化指标[层粘连蛋白(LN)、透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)]、免疫功能(CD4+、CD8+)、肾功能指标[尿蛋白排泄率(UAER)、胱抑素C(CysC)、血肌酐(Scr)]。结果 观察组患者的临床治疗总有效率89.19%高于对照组的54.05%(P<0.05)。治疗后,两组LN、HA、PCⅢ、Ⅳ-C均优于治疗前,且观察组患者LN、HA、PCⅢ、Ⅳ-C分别为(91.68±10.16)、(176.15±20.27)、(127.11±14.92)、(95.32±10.27)ng/ml,均优于对照组患者的(103.56±12.56)、(206.19±23.62)、(145.75±15.82)、(110.64±13.25)ng/ml(P<0.05)。治疗后,两组CD4+、CD8+均优于治疗前,且观察组CD4+、CD8+分别为(48.97±5.24)%、(19.82±2.52)%,均优于对照组的(42.79±4.99)%、(24.86±3.61)%(P<0.05)。治疗后,两组UAER、CysC、Scr均优于治疗前,且观察组UAER、CysC、Scr分别为(106.25±7.91)μg/min、(114.53±15.49)μmol/L、(1.31±0.06)mg/L,优于对照组的(172.51±5.79)μg/min、(122.49±12.48)μmol/L、(1.59±0.11)mg/L(P<0.05)。结论 早期2型糖尿病肾病患者通过达格列净联合雷公藤进行治疗,能够有效提升临床疗效,改善治疗指标,值得推广。

Objective To study the clinical efficacy of dapagliflozin combined with tripterygium wilfordii in the treatment of early type 2 diabetic nephropathy.Methods 74 patients with early type 2 diabetic nephropathy were divided into an observation group and a control group according to random number table method,with 37 cases in each group.The control group was treated with tripterygium wilfordii,and the observation group was treated with dapagliflozin on the basis of the control group.Both groups were compared in terms of total effective rate of clinical treatment,serum renal fibrosis indicators[laminin(LN),hyaluronic acid(HA),typeⅢprocollagen(PCⅢ),typeⅣcollagen(Ⅳ-C)],immune function(CD4+,CD8+),renal function indicators[urine albumin excretion rate(UAER),cystatin C(CysC),and serum creatinine(Scr)].Results The total effective rate of clinical treatment of the observation group was 89.19%,which was higher than 54.05%of the control group(P<0.05).After treatment,LN,HA,PCⅢandⅣ-C in both groups were better than those before treatment;LN,HA,PCⅢandⅣ-C in the observation group were(91.68±10.16),(176.15±20.27),(127.11±14.92)and(95.32±10.27)ng/ml,which were better than(103.56±12.56),(206.19±23.62),(145.75±15.82)and(110.64±13.25)ng/ml in the control group(P<0.05).After treatment,CD4+and CD8+in both groups were better than those before treatment;CD4+and CD8+in the observation group were(48.97±5.24)%and(19.82±2.52)%,which were better than(42.79±4.99)%and(24.86±3.61)%in the control group(P<0.05).After treatment,UAER,CysC and Scr in both groups were better than those before treatment;UAER,CysC and Scr in the observation group were(106.25±7.91)μg/min,(114.53±15.49)μmol/L and(1.31±0.06)mg/L,which were better than(172.51±5.79)μg/min,(122.49±12.48)μmol/L and(1.59±0.11)mg/L in the control group(P<0.05).Conclusion The treatment of patients with early type 2 diabetic nephropathy by dapagliflozin combined with tripterygium wilfordii can effectively improve clinical efficacy and treatment indicators,and it is worth promoting.