参芪降糖片联合达格列净治疗糖尿病肾病的疗效及对血清S1P、SFRP-4和血液流变学的影响  

Efficacy of Shenqi Jiangtang tablets combined with danagliflozin for diabetic nephropathy and its effect on serum S1P,SFRP-4 and blood rheology

作　　者：陈芳 杨巍 李园园 刘信秋 CHEN Fang;YANG Wei;LI Yuan-yuan(Department of Nephrology,Bozhou Hospital of Traditional Chinese Medicine,Bozhou Anhui 236800,China;Department of Endocrinology,Bozhou Hospital of Traditional Chinese Medicine,Bozhou Anhui 236800,China)

机构地区：[1]亳州市中医院肾病科,安徽亳州236800 [2]亳州市中医院内分泌科,安徽亳州236800 [3]亳州市中医院药剂科,安徽亳州236800

出　　处：《临床和实验医学杂志》2023年第15期1586-1590,共5页Journal of Clinical and Experimental Medicine

基　　金：2022年安徽省红十字基金中医药传承创新发展研究项目(编号:2022ZYD29)。

摘　　要：目的探讨参芪降糖片联合达格列净治疗糖尿病肾病的疗效及对血清1-磷酸鞘氨醇(S1P)、分泌型卷曲相关蛋白4(SFRP-4)和血液流变学的影响。方法前瞻性选取2020年7月至2022年7月亳州市中医院收治的76例糖尿病肾病患者作为研究对象,按照随机数字表法分为对照组和观察组,每组各38例。两组均予以西医常规治疗,在此基础上,对照组加用达格列净治疗,观察组加用参芪降糖片联合达格列净治疗。比较两组临床总有效率,治疗后的空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、尿微量白蛋白(m-Alb)、S1P、SFRP-4、血液流变学指标[全血高切黏度(ηbH)、全血中切黏度(ηbM)、全血低切黏度(ηbL)、血浆黏度(ηp)、红细胞聚集指数(AI)]及不良反应发生率。结果观察组临床总有效率为89.47%,高于对照组(78.95%),差异有统计学意义(P<0.05)。观察组治疗后FPG、2 hPG、HbA1c、m-Alb水平分别为(5.46±0.34)mmol/L、(7.06±1.01)mmol/L、(6.45±0.33)%、(32.16±8.27)μg/min,均低于对照组[(6.23±0.52)mmol/L、(9.01±1.23)mmol/L、(7.51±0.46)%、(48.76±14.08)μg/min],差异均有统计学意义(P<0.05)。观察组治疗后S1P、SFRP-4水平分别为(332.16±45.89)μg/L、(33.46±5.93)ng/mL,均高于对照组[(286.95±38.74)μg/L、(23.16±4.05)ng/mL],差异均有统计学意义(P<0.05)。观察组治疗后ηbH、ηbM、ηbL、ηp、AI水平分别为(3.08±3.17)mPa·s、(5.23±0.46)mPa·s、(6.68±0.87)mPa·s、(1.02±0.34)mPa·s、3.03±1.15,均低于对照组[(5.16±0.46)mPa·s、(7.61±0.78)mPa·s、(9.72±1.23)mPa·s、(2.11±0.45)mPa·s、4.46±1.28],差异均有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论参芪降糖片联合达格列净治疗糖尿病肾病的疗效显著,可有效降低血清S1P、SFRP-4水平,改善血液流变学,值得进一步研究应用。Objective To explore the effect of Shenqi Jiangtang tablets combined with dagliflozin in diabetic nephropathy on serum sphingosine 1-phosphate(S1P),secreted curl-related protein 4(SFRP-4)and blood rheology.Methods A total of 76 diabetic nephropathy patients admitted to Bozhou Hospital of Traditional Chinese Medicine from July 2020 to July 2022 were selected as study subjects and randomly divided into control group and observation group,38 cases in each group.Both groups received conventional western medicine treatment.On this basis,the control group was treated with dagliflozin,and the observation group was treated with Shenqi Jiangtang tablets combined with dagliflozin.The total clinical effective rate,fasting blood glucose(FPG),2 h postdietary blood glucose(2 hPG),glycated hemoglobin(HbA1c),urinary microalbumin(m-Alb),S1P,SFRP-4,hemorheological indexes[whole blood high tangential viscosity(ηbH),whole blood low tangential viscosity(ηbL)and plasma viscosity(ηp),red blood cell aggregation index(AI)]after treatment,and incidence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 89.47%,which was higher than that of the control group(78.95%),the difference was statistically significant(P<0.05).After treatment,the FPG,2 hPG,HbA1c and m-Alb levels in observation group were(5.46±0.34)mmol/L,(7.06±1.01)mmol/L,(6.45±0.33)%,(32.16±8.27)μg/min,which were lower than those in the control group[(6.23±0.52)mmol/L,(9.01±1.23)mmol/L,(7.51±0.46)%,(48.76±14.08)μg/min],the differences were statistically significant(P<0.05).After treatment,the levels of S1P and SFRP-4 in the observation group were(332.16±45.89)μg/L,(33.46±5.93)ng/mL,which were higher than those in the control group[(286.95±38.74)μg/L,(23.16±4.05)ng/mL],the differences were statistically significant(P<0.05).After treatment,the levels ofηbH,ηbM,ηbL,ηp and AI in the observation group were(3.08±3.17)mPa·s,(5.23±0.46)mPa·s,(6.68±0.87)mPa·s,(1.02±0.34)mPa·s,3.03±1.15,which

关 键 词：糖尿病肾病 血液流变学 参芪降糖片 达格列净 1-磷酸鞘氨醇 分泌型卷曲相关蛋白4 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]