益肾活血化湿汤联合非奈利酮治疗女性糖尿病肾病脾虚湿盛兼血瘀证患者的临床效果

Clinical effect of Yishen Huoxue Huashi Decoction combined with Finerenone in the treatment of female diabetic nephropathy patients with spleen deficiency,dampness,and blood stasis

目的 探讨益肾活血化湿汤联合非奈利酮治疗女性糖尿病肾病(DN)脾虚湿盛兼血瘀证患者的临床效果。方法 选取2022年2月至2024年3月甘肃省第二人民医院肾内科收治的106例女性DN患者为研究对象,采用随机数字表法分为研究组和对照组,每组各53例。对照组采用常规对症治疗联合非奈利酮,研究组在对照组的基础上采取益肾活血化湿汤。比较两组中医症状积分、临床疗效、肾损伤指标[胱抑素C(CysC)、肾损伤分子-1(KIM-1)、转化生长因子-β1(TGF-β1)、骨形成蛋白-7(BMP-7)]、不良反应。结果治疗后,两组中医症状积分较治疗前下降,且研究组中医症状积分低于对照组(P<0.05)。研究组治疗总有效率高于对照组(P <0.05)。治疗后,两组CysC、KIM-1、TGF-β1较治疗前下降,BMP-7较治疗前升高,且研究组CysC、KIM-1、TGF-β1低于对照组,BMP-7高于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论 采取益肾活血化湿汤联合非奈利酮治疗女性DN患者,能有效缓解临床症状,减轻肾损伤,且不增加不良反应。

Objective To explore the clinical effect of Yishen Huoxue Huashi Decoction combined with Finerenone in the treatment of female diabetic nephropathy(DN)patients with spleen deficiency,dampness,and blood stasis.Methods A total of 106 patients with DN admitted to the Department of Nephrology,the Second People’s Hospital of Gansu Province from February 2022 to March 2024 were selected as the study objects,and were divided into study group and control group by random number table method,with 53 cases in each group.The control group was treated with conventional symptomatic treatment combined with Finerenone,and the study group was treated with Yishen Huoxue Huashi Decoction on the basis of the control group.The traditional Chinese medicine symptom score,clinical efficacy,kidney injury indexes(cystatin C[CysC],kidney injury molecular-1[KIM-1],transforming growth factor-β1[TGF-β1],bone morphogenetic protein-7[BMP-7]),and adverse reactions were compared between the two groups.Results After treatment,the traditional Chinese medicine symptom score of the two groups was lower than that before treatment,and the traditional Chinese medicine symptom score of the study group was lower than that of the control group(P<0.05).The total effective rate of the study group was higher than that of the control group(P<0.05).After treatment,the CysC,KIM-1,and TGF-β1 in both groups were decreased,and BMP-7 was increased,the CysC,KIM-1,and TGF-β1 in the study group were lower than those in the control group,and BMP-7 was higher than that in the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Yishen Huoxue Huashi Decoction combined with Finerenone in the treatment of female patients with DN can effectively relieve the clinical symptoms and reduce kidney injury,does not increase adverse reactions.