自拟糖肾平方联合达格列净治疗超重或肥胖糖尿病肾病患者的效果  

Effect of Self-prescribed Tangshenping Recipe Combined with Dapagliflozin for Overweight/Obese Patients with Diabetic Nephropathy

作　　者：郑春梅 李丽莉 冯翠娟 李娜[1] ZHENG Chunmei;LI Lili;FENG Cuijuan;LI Na(Department of Endocrinology,the Second Hospital of Baoding City,Baoding,Hebei 071000,China)

机构地区：[1]保定市第二医院内分泌科,河北保定071000

出　　处：《临床误诊误治》2023年第5期148-152,共5页Clinical Misdiagnosis & Mistherapy

基　　金：河北省卫生健康委科研基金项目(20200171);保定市科学技术局项目(2041ZF018)。

摘　　要：目的探讨自拟糖肾平方联合达格列净治疗超重或肥胖糖尿病肾病(DN)患者的效果。方法选取2020年1月—2022年6月收治的超重或肥胖DN 104例,按照随机数字表法分为西医组和中西医组,各52例。西医组给予达格列净治疗,中西医组在西医组基础上给予自拟糖肾平方治疗。比较2组临床疗效及治疗前、治疗1个月后、治疗3个月后中医证候积分、体质量指数(BMI)、腰围、血糖指标、脂代谢指标及肾功能指标。记录2组不良反应发生情况。结果治疗3个月后,中西医组总有效率高于西医组(P<0.05)。中西医组治疗1、3个月后倦怠乏力、肢沉体胖、咽干口燥、头晕目眩、五心烦热、失眠健忘中医证候积分低于西医组(P<0.05)。中西医组治疗1、3个月后BMI、腰围、空腹血糖、糖化血红蛋白、三酰甘油、低密度脂蛋白胆固醇、总胆固醇低于西医组,高密度脂蛋白胆固醇高于西医组(P<0.05)。中西医组治疗1、3个月后血肌酐、血尿素、尿白蛋白排泄率低于西医组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论自拟糖肾平方联合达格列净治疗超重或肥胖DN,可改善患者糖脂代谢与超重或肥胖状态,促进临床症状体征缓解,减轻肾损害,提高疗效,具有安全性。Objective To investigate the effect of self-prescribed Tangshenping recipe combined with Dapagliflozin in the treatment of overweight/obese patients with diabetic nephropathy(DN).Methods A total of 104 overweight or obese patients with DN admitted from January 2020 to June 2022 were selected and divided into Western medicine group(n=52)and Traditional Chinese Medicine and Western medicine(TCM-WM)group(n=52)according to random number table.The Western medicine group was given Dapagliflozin,and the TCM-WM group was given self-prescribed Tangshenping recipe on the basis of the Western medicine group.The clinical efficacy,TCM syndrome score,body mass index(BMI),waist circumference,blood glucose index,lipid metabolism indicators and renal function index of the two groups were compared before treatment,and at 1 month after treatment and 3 months after treatment.The occurrence of adverse reactions in the two groups was recorded.Results At 3 months after treatment,the total effective rate of TCM-WM group was higher than that of Western medicine group(P<0.05).At 1 and 3 months after treatment,the TCM syndrome scores of TCM-WM group were lower than those of Western medicine group(P<0.05).At 1 and 3 months after treatment,BMI,waist circumference,fasting blood glucose,glycosylated hemoglobin,triacylglycerol,low density lipoprotein cholesterol and total cholesterol in TCM-WM group were lower than those in Western medicine group,but high density lipoprotein cholesterol was higher than that in Western medicine group(P<0.05).The excretion rates of creatinine,blood urea and urinary albumin in TCM-WM group were lower than those in Western medicine group at 1 month and 3 months after treatment(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Self-prescribed Tangshenping recipe combined with Dapagliflozin in the treatment of overweight or obese patients with DN can improve glucose and lipid metabolism and overweight or obese status of patients,promote the rel

关 键 词：糖尿病肾病 自拟糖肾平方 达格列净 超重 肥胖 血糖 胆固醇 血尿素 

分 类 号：R587.24[医药卫生—内分泌]