雷公藤多苷片联合钠-葡萄糖协同转运蛋白2抑制剂对糖尿病肾病肾功能及蛋白尿水平影响研究  

Effects of Tripterygium Wilfordii Polyglycoside Tablet Combined with Natrium-Glucose Cotransporter 2 Inhibitor on Renal Function and Proteinuria in Patients with Diabetic Nephropathy

作　　者：马爱景[1] 姚曦 MA Aijing;YAO Xi(Department of Nephrology,Chongqing No.9 People's Hospital,Chongqing 400700,China)

机构地区：[1]重庆市第九人民医院肾内科,重庆400700

出　　处：《中华中医药学刊》2020年第8期200-203,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：重庆市科委项目(cstc2015shmszx121068)。

摘　　要：目的探究雷公藤多苷片联合钠-葡萄糖协同转运蛋白2抑制剂治疗糖尿病肾病患者临床疗效。方法共计纳入102例糖尿病肾病患者,并采取随机数字表法将102例患者分为观察组与对照组,每组各51例,给予对照组所有患者钠-葡萄糖协同转运蛋白2抑制剂(达格列净片-安达唐)治疗,给予观察组患者雷公藤多苷片联合钠-葡萄糖协同转运蛋白2抑制剂治疗,比较两组患者经治疗后临床疗效、治疗前后患者肾功能指标变化、血清炎性因子水平变化、蛋白尿水平变化及血清免疫因子水平变化、患者症状积分变化、治疗过程中药物不良反应情况及患者对本次治疗满意程度。结果较对照组60.78%(31/51),观察组患者80.39%(41/51)经临床治疗后总有效率更高(P<0.05);治疗前,两组患者血尿素氮(BUN)、血肌酐(Scr)等肾功能指标、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)等血清炎性因子水平、24 h蛋白尿定量、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、补体C3、补体C4等血清免疫因子水平、症状积分均相当,P>0.05,未见统计学差异;经治疗后,各组患者BUN、Scr、hs-CRP、IL-6、IL-8、24 h蛋白尿定量、IgA、IgG、C3、C4、症状积分等指标均一定程度改善,观察组患者治疗后BUN、Scr、hs-CRP、IL-6、IL-8、24 h蛋白尿定量、IgA、IgG、C3、C4、症状积分等指标均优于对照组,P<0.05;观察组患者治疗过程中不良反应为1.96%(1/51),与对照组不良反应相当3.92%(2/51)(P>0.05);观察组患者治疗满意率98.04%(50/51)显著高于对照组84.31%(43/51)(P<0.05)。结论雷公藤多苷片联合钠-葡萄糖协同转运蛋白2抑制剂治疗糖尿病肾病患者临床疗效显著,患者肝肾功能显著改善,症状缓解,免疫力提升,且不良反应少,安全性高,患者十分满意,值得临床推广以及应用。Objective To explore the clinical efficacy of Tripterygium Wilfordii Polyglycoside Tablets combined with natrium-glucose cotransporter 2 inhibitors in the treatment of diabetic nephropathy.Methods This study included 102 patients with diabetic nephropathy.By the random number table method,102 patients were divided into observation group and control group,with 51 cases in each group.The control group(51 cases)was given natrium-glucose cotransporter 2 inhibitors(Dapagilflozin Tablets-Forxiga).The observation group(51 cases)used Tripterygium Wilfordii Glycosides Tabletscombinedwith natrium-glucose cotransporter 2 inhibitors.The clinical efficacy,changes of renal function,changes of serum inflammatory factors,changes of proteinuria and serum immune factors,changes of symptom scores,adverse drug reactions in the treatment process and patients’satisfaction with the treatment were compared between the two groups.Results Compared with the control group 60.78%(31/51),the observation grouphad a higher total effective rate 80.39%(41/51)after clinical treatment(P<0.05).Beforetreatment,two groups’blood urea nitrogen(BUN),serum creatinine(Scr),renal function indexes such ashypersensitive C-reactive protein(hs-CRP)and inflammatory cytokinesinterleukin 6(IL-6)and interleukin 8(IL-8)and serum levels of 24 h proteinuria quantitative,immunoglobulin A(IgA),immunoglobulin G(IgG),C3 and C4 and symptom integral werenot significant(P>0.05).After treatment,BUN,Scr,hs-CRP,IL-6,IL-8,24 h proteinuria,IgA,IgG,C3,C4,symptom score and other indicators were all improved to a certain extent in each group.And those in the observation group were better than those in the control group(P<0.05).Adverse reaction incidence in the observation group was 1.96%(1/51),which was equivalent to 3.92%(2/51)in the control group(P>0.05).The satisfaction rate of patients in the observation group 98.04%(50/51)was significantly higher than that in the control group(84.31%)(P<0.05).Conclusion Tripterygium Wilfordii Polyglycoside Tablets combined with natrium-gluc

关 键 词：糖尿病肾病 雷公藤多苷片 钠-葡萄糖协同转运蛋白2抑制剂 达格列净片 肾功能 蛋白尿 

分 类 号：R259.872[医药卫生—中西医结合]