芪葵颗粒联合度拉糖肽治疗老年临床期糖尿病肾病的近期疗效  

Short⁃term effect of Qi⁃Kui granules combined with dulaglutide in the treatment of clinical stage of diabetic kidney disease in the elderly

作　　者：王丽娟 冯飞 周静波 阮园 查敏 浦强[2] 余江毅 WANG Li-juan;FENG Fei;ZHOU Jing-bo;RUAN Yuan;ZHA Min;PU Qiang;YU Jiang-yi(Department of Endocrinology,Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,Nanjing 210029,China;Department of Cardiology,Rugao Hospital of Traditional Chinese Medicine,Nantong 226500,China)

机构地区：[1]南京中医药大学附属医院内分泌科,江苏省南京市210029 [2]如皋市中医院心病科,江苏省南通市226500

出　　处：《实用老年医学》2023年第4期348-351,共4页Practical Geriatrics

基　　金：国家自然科学基金资助项目(82174293);江苏省中医院院级创新发展基金专项课题(Y2021CX30);第5批江苏省名老中医药专家传承工作室建设项目(苏中医科教[2021]7)。

摘　　要：目的 观察芪葵颗粒联合度拉糖肽对老年临床期糖尿病肾病(DKD)的近期疗效。方法 选取2019年11月至2021年6月南京中医药大学附属医院内分泌科住院的老年临床期DKD病人80例,采用随机数表法分为试验组及对照组,每组各40例。对照组予度拉糖肽注射液1.5 mg每周1次,皮下注射;试验组在对照组的基础上联合芪葵颗粒10 g, 3次/d,口服。2组均治疗12周。比较2组治疗前后血糖(FPG、HbA1c)、血压(SBP、DBP)、血脂(TC、TG、LDL-C、HDL-C)、肾脏指标[血肌酐(Scr)、尿白蛋白肌酐比值(UACR)、24小时尿蛋白定量(24hUTP)]水平变化。结果 研究期间,试验组脱落5例,最终完成有效病例35例;对照组脱落4例,最终完成有效病例36例。治疗后,2组FPG、HbA1c、SBP、DBP、TC、TG、LDL-C水平均较治疗前明显下降(P<0.05或P<0.01),但2组间差异无统计学意义(P>0.05);2组Scr、UACR、24hUTP水平均较治疗前明显下降(P<0.05或P<0.01),且试验组下降幅度均优于对照组(P<0.05)。试验组的总有效率为88.57%,明显优于对照组的55.56%(P<0.01)。结论 芪葵颗粒联合度拉糖肽可明显降低老年临床期DKD病人Scr及尿蛋白水平,有较好的肾脏保护作用。Objective To observe the short-term effect of Qi-Kui granules combined with dulaglutide in the treatment of clinical stage of diabetic kidney disease(DKD)in the elderly.Methods A total of 80 elderly patients with clinical stage of DKD hospitalized in the Department of Endocrinology,Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from November 2019 to June 2021 were enrolled and divided into experiment group and control group by random number table,with 40 cases in each group.The control group was subcutaneously injected with dulaglutide injection 1.5 mg once a week;The experiment group took Qi-Kui granules 10 g on the basis of the control group,3 times daily.Both groups were treated for 12 weeks.The levels of fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),systolic blood pressure(SBP),diastolic blood pressure(DBP),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),serum creatinine(Scr),urinary albumin/creatinine ratio(UACR)and 24 hours urine protein(24hUTP)in both groups before and after treatment were compared.Results During the study,5 cases fell off in the experiment group,and 4 cases fell off in the control group.After treatment,the levels of FPG,HbA1c,SBP,DBP,TC,TG and LDL-C in both groups were significantly lower than those before treatment(P<0.05 or P<0.01),but there were no statistical differences between the two groups(P>0.05);The levels of Scr,UACR and 24hUTP in both groups were significantly decreased after treatment(P<0.05 or P<0.01),especially in the experiment group(P<0.05).The total effective rate in the experiment group was higher than that in the control group(88.57%vs 55.56%,P<0.01).Conclusions Qi-Kui granules combined with dulaglutide can significantly reduce the levels of Scr and urinary protein in the elderly patients with clinical stage of DKD,and they show protective effect on renal.

关 键 词：老年人 糖尿病肾病 芪葵颗粒 度拉糖肽 

分 类 号：R692.5[医药卫生—泌尿科学]