金胡固肾方降低糖尿病肾病患者尿蛋白及血尿酸的临床疗效分析  

Clinical effect of Jinhu Gushen prescription in reducing urinary protein and blood uric acid in patients with diabetic kidney disease

作　　者：李奕璇 黄雅静 魏凡翔 李文轩 徐丽丽[1] 王颜刚[1] LI Yixuan;HUANG Yajing;WEI Fanxiang;LI Wenxuan;XU Lili;WANG Yangang(Department of Endocrinology,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院内分泌科,山东青岛266003 [2]临沂市中心医院内分泌科

出　　处：《精准医学杂志》2025年第2期102-107,共6页Journal of Precision Medicine

基　　金：山东省中西医结合防治痛风及高尿酸血症项目(S190009280000)。

摘　　要：目的评估金胡固肾方治疗糖尿病肾病(diabetic kidney disease,DKD)的临床效果。方法对我院内分泌科2018年1月—2021年5月收治的157例DKD患者进行回顾性队列研究,依据治疗方案分为暴露组(金胡固肾方+基础DKD治疗)和非暴露组(黄葵胶囊+基础DKD治疗),进一步依据蛋白尿程度将每组患者分为微量及大量蛋白尿者。收集并比较暴露组和非暴露组患者治疗前后的尿蛋白/肌酐比值(UACR)和血肌酐水平。对2021年6月—2024年1月我院内分泌科收治的96例DKD患者进行随机对照试验,采用简单随机抽样法将患者随机分为中药治疗组(金胡固肾方+基础DKD治疗)和基础对照组(黄葵胶囊+基础DKD治疗),进一步依据蛋白尿程度将每组患者分为微量及大量蛋白尿者。检测并比较两组患者治疗前后的UACR、血肌酐水平及血尿酸水平。结果在回顾性队列研究中,对于微量蛋白尿患者,暴露组治疗后血肌酐水平显著低于非暴露组(t=2.800,P<0.05),血肌酐下降患者构成比显著高于非暴露组(χ^(2)=8.771,P<0.05)。对于大量蛋白尿患者,暴露组治疗后UACR显著低于非暴露组(t=2.313,P<0.05),且UACR下降率显著高于非暴露组(t=-4.804,P<0.05)。在随机对照试验中,对于微量蛋白尿患者,中药治疗组治疗后血肌酐水平及治疗前后血肌酐水平差值、血尿酸水平差值显著低于基础治疗组(t=2.461~6.364,P<0.05),血肌酐水平和血尿酸水平下降患者构成比显著高于基础治疗组(χ^(2)=5.034、4.912,P<0.05)。对于大量蛋白尿患者,中药治疗组治疗后UACR、血尿酸水平及治疗前后血尿酸水平差值均显著低于基础治疗组(t=2.150~3.223,P<0.05),UACR下降率、血尿酸下降患者构成比显著高于基础治疗组(t=-6.597,χ^(2)=9.641,P<0.05)。结论金胡固肾方能稳定DKD患者血尿酸水平,并有效降低大量蛋白尿DKD患者的UACR,值得临床推广使用。Objective To investigate the clinical effect of Jinhu Gushen prescription in the treatment of diabetic kidney disease(DKD).Methods A retrospective cohort study was conducted among 157 patients with DKD who were admitted to Department of Endocrinology in our hospital from January 2018 to May 2021,and according to the treatment regimen,they were divided into exposure group(Jinhu Gushen prescription and basic treatment for DKD)and non-exposure group(Huangkui Capsule and basic treatment for DKD);according to the degree of proteinuria,the patients in each group were further divided into microalbuminuria subgroup and macroalbuminuria subgroup.The two groups were compared in terms of urinary albumin-to-creatinine ratio(UACR)and serum creatinine before and after treatment.In addition,a randomized controlled trial was conducted among 96 DKD patients who were admitted to Department of Endocrinology in our hospital from June 2021 to January 2024,and they were randomly divided into traditional Chinese medicine(TCM)treatment group(Jinhu Gushen prescription and basic treatment for DKD)and basic treatment group(Huangkui Capsule and basic treatment for DKD)using the simple random sampling method;according to the degree of proteinuria,the patients in each group were further divided into microalbuminuria subgroup and macroalbuminuria subgroup.The two groups were compared in terms of UACR,serum creatinine,and serum uric acid before and after treatment.Results In the retrospective cohort study,for patients with microalbuminuria,the exposure group had a significantly lower level of serum creatinine than the non-exposure group after treatment(t=2.800,P<0.05),as well as a significantly higher proportion of patients with a reduction in serum creatinine(χ^(2)=8.771,P<0.05).For patients with macroalbuminuria,compared with the non-exposure group,the exposure group had a significantly lower UACR(t=2.313,P<0.05)and a significantly higher rate of reduction in UACR(t=-4.804,P<0.05).In the randomized controlled trial,for patients with microalb

关 键 词：糖尿病肾病 胡芦巴属 金樱子 葛根 黄葵胶囊 白蛋白尿 尿酸 肌酸酐 治疗结果 

分 类 号：R259[医药卫生—中西医结合] R587.24[医药卫生—中医内科学]