金水宝联合胰高血糖素样肽-1受体激动剂治疗对糖尿病肾病患者肾功能、肾脏血流及血管内皮功能的影响  

Effect of Jinshuibao Capsule(金水宝胶囊)Combined with GLP-1 Receptor Agonist on Renal Function,Renal Blood Flow and Vascular Endothelial Function in Diabetic Nephropathy Patients

作　　者：林叶[1] 庄新鸿 张丽[1] 李佳 王凤娟 LIN Ye;ZHUANG Xinhong;ZHANG Li;LI Jia;WANG Fengjuan(Second Affiliated Hospital of Hainan Medical College,Haikou 570311,Hainan,China)

机构地区：[1]海南医学院第二附属医院,海南海口570311

出　　处：《中华中医药学刊》2024年第6期240-243,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：海南省卫生健康行业科研项目(20A200165)。

摘　　要：目的 探究金水宝联合胰高血糖素样肽-1受体激动剂(glucagon-likepeptide-1,LP-1)治疗对糖尿病肾病患者肾功能、肾脏血流及血管内皮功能的影响。方法 采用随机数字表法将2020年3月—2022年8月收治的96例糖尿病肾病患者分为观察组(n=48)与对照组(n=48)。对照组采用GLP-1受体激动剂,观察组在此基础上联合使用金水宝治疗。观察两组患者治疗前后中医证候积分、肾功能、肾脏血、氧化应激指标及血管内皮功能水平。观察两组患者临床疗效和不良反应发生率。结果 两组患者治疗前尿频、精神萎靡、口渴喜饮和易饥多食中医证候积分差异无统计学意义(P>0.05)。治疗后,观察组尿频、精神萎靡、口渴喜饮和易饥多食中医证候积分显著低于对照组(P<0.05)。两组患者治疗前24 h尿蛋白定量、同型半胱氨酸(homocysteine, Hcy)、尿白蛋白排泄率(urinary albumin excretion, UAER)、血清肌酐(serum creatinine, Scr)水平差异无统计学意义(P>0.05)。治疗后,观察组24 h尿蛋白定量、Hcy、UAER和Scr水平显著低于对照组(P<0.05)。两组患者治疗前段间动脉血流灌注指数(Perfusion Index, PI)、段间动脉胰岛素(Regular Insulin, RI)和叶间动脉RI水平差异无统计学意义(P>0.05)。治疗后,观察组段间动脉PI、段间动脉RI和叶间动脉RI水平显著低于对照组(P<0.05)。两组患者治疗前丙二醛(malondialdehyde;malonic dialdehyde, MDA)、脂质过氧化氢(lipid peroxidation, LPO)、谷胱甘肽过氧化物酶(glutathione Peroxidase, GPX)、总抗氧化能力(total antioxidative capability, T-AOC)水平差异无统计学意义(P>0.05)。治疗后,观察组MDA、LPO水平显著低于对照组,且GPX和T-AOC水平显著高于对照组(P<0.05)。观察组总有效率为89.58%(43/48)显著高于对照组72.92%(35/48)(χ^(2)=4.376,P=0.036)。观察组总不良反应发生率为8.32%(4/48),略低于对照组的10.42%(5/48),但差异无统计学意义(χ^(2)=0.123,P=0.726)。�Objective To investigate the effects of Jinshuibao Capsule(金水宝胶囊)combined with GLP-1 receptor agonist on renal function,renal blood flow and vascular endothelial function in diabetic nephropathy patients.Methods Ninety-six pa-tients with diabetic nephropathy admitted to the hospital from March 2020 to August 2022 were classified into two groups by ran-dom number table method,each with 48 cases.The control group received GLP-1 receptor agonist,based on this,the observation group received Jinshuibao Capsule.The TCM syndrome scores,renal function parameters,renal blood flow parameters,oxidative stress indexes and vascular endothelial function indexes were compared between two groups.Then the clinical efficacy rate and adverse reaction rate were compared between two groups.Results The TCM syndrome scores such as frequent urination,mental depression,polydipsia and polyphagia demonstrated no statistical difference between two groups before treatment(P>0.05),while the above TCM syndrome scores of the observation group were notably lower than those of the control group after treatment(P<0.05).The 24-hour urine protein,homocysteine(Hcy),urinary albumin excretion rate(UAER)and serum creatinine(SCr)yielded no statistical difference between two groups before treatment(P>0.05),while the four renal function parameters of the observation group were lower than those of the control group after treatment(P<0.05).The pulsation index(PI)of renal segmental artery and the resistance index(RI)values of renal segmental artery and interlobar artery demonstrated no statistical difference between two groups before treatment(P>0.05),while the three renal blood flow parameters of the observation group were lower than those of the control group after treatment(P<0.05).The activities of malondialdehyde(MDA),lipid peroxida-tion(LPO),glutathione peroxidase(GPX)and total antioxidant capacity(T-AOC)presented no statistical difference between two groups before treatment(P>0.05).After treatment,a decrease in MDA and LPO along with an incre

关 键 词：金水宝 GLP-1受体激动剂 糖尿病肾病 肾功能 肾脏血流 血管内皮功能 

分 类 号：R255.4[医药卫生—中医内科学]