黄葵胶囊联合司美格鲁肽治疗老年糖尿病肾病的临床疗效分析

doi:10.3969/j.issn.1003-9198.2024.10.009

摘要/Abstract

摘要： 目的分析黄葵胶囊联合司美格鲁肽治疗老年糖尿病肾病的临床疗效。方法选取2021年6月至2023年8月在本院就诊的老年糖尿病肾病病人102例,采用随机数表法将其分成对照组和研究组,各51例。对照组采用司美格鲁肽治疗,研究组在对照组的基础上采用黄葵胶囊治疗。2组均治疗3个月。对比2组血糖指标、肾功能指标、临床疗效、炎症反应及不良反应。结果治疗后,2组HbA1c、餐后2 h血糖(2hPPG)、FPG水平均显著降低(P＜0.05),但2组间差异没有统计学意义(P＞0.05)。治疗后,2组血肌酐、尿微量白蛋白与尿肌酐比值(UACR)、24 h尿蛋白定量(24hUTP)均显著降低(P＜0.05),且研究组显著低于对照组(P＜0.05)。研究组总有效率高于对照组(90.20%比72.55%,P＜0.05)。治疗后,2组血清转化生长因子β(TGF-β)、细胞黏附分子-1(ICAM-1)、高迁移率族蛋白B1(HMGB1)水平均降低(P＜0.05),且研究组下降更显著(P＜0.05)。2组间总不良反应发生率差异没有统计学意义(P＞0.05)。结论司美格鲁肽联合黄葵胶囊可保护老年糖尿病肾病病人肾功能,减轻炎症反应,维持病人血糖稳定,疗效显著且安全性良好。

关键词: 黄葵胶囊, 司美格鲁肽, 老年人, 糖尿病肾病, 临床疗效, 安全性

Abstract: Objective To analyze the clinical effects of Huangkui capsule combined with semaglutide in the treatment of diabetic nephropathy in the elderly. Methods A total of 102 elderly patients with diabetic nephropathy treated in Lianyungang First People’s Hospital from June 2021 to August 2023 were selected and divided into control group and study group by random number table method, with 51 cases in each group. The control group was treated with semaglutide, and the study group was treated with Huangkui capsule on the basis of the control group. Both groups were treated for 3 months. The levels of blood glucose and renal function, clinical efficacy, inflammatory reactions and adverse reactions were compared between the two groups. Results After treatment, the levels of glycosylated hemoglobin (HbA1c), 2 h postprandial plasma glucose (2hPPG) and fasting plasma glucose (FPG) in the two groups were significantly decreased (P<0.05), with no significant differences between the two groups (P>0.05). After treatment, the levels of serum creatinine, urinary albumin-to-creatinine ratio (UACR) and 24 h urinary protein quantity (24hUTP) in the two groups were significantly decreased (P<0.05), especially in the study group (P<0.05). The total effective rate in the study group was higher than that in the control group (90.20% vs. 72.55%, P<0.05). After treatment, the levels of serum transforming growth factor β (TGF-β), intercellular cell adhesion molecule-1 (ICAM-1) and high mobility group protein B1 (HMGB1) in the two groups were significantly decreased (P<0.05), especially in the study group (P<0.05). There was no difference in the total incidence rate of adverse reactions between the two groups (P>0.05). Conclusions Semaglutide combined with Huangkui capsule can protect renal function in the elderly patients with diabetic nephropathy, reduce inflammatory response and maintain stable blood glucose, with significant effect and good safety.

Key words: Huangkui capsule, semaglutide, aged, diabetic nephropathy, clinical effect, security

中图分类号:

R 587.2

李雨涵, 李达, 吴桓宇. 黄葵胶囊联合司美格鲁肽治疗老年糖尿病肾病的临床疗效分析[J]. 实用老年医学, 2024, 38(10): 1007-1010.

LI Yuhan, LI Da, WU Hengyu. Efficacy of Huangkui capsule combined with semaglutide in the treatment of diabetic nephropathy in the elderly[J]. Practical Geriatrics, 2024, 38(10): 1007-1010.

参考文献

[1] 梁凯,王川,闫飞,等. 列线图预测中国成人3年后进展为2型糖尿病风险的研究[J]. 中华糖尿病杂志,2021,13(4):422-428.
[2] LI X, LU L, HOU W, et al. Epigenetics in the pathogenesis of diabetic nephropathy[J]. Acta Biochim Biophys Sin, 2022,54(2):163-172.
[3] YANG M, CHEN W, HE L, et al. Intermittent fasting—a healthy dietary pattern for diabetic nephropathy[J]. Nutrients, 2022, 14(19):3995.
[4] CAO X, CHEN P. The effects of alprostadil combined with alpha-lipoic acid in the treatment of senile diabetic nephropathy[J]. Am J Transl Res, 2021,13(9):10823-10829.
[5] MIMA A, KIDOOKA S, NAKAMOTO T, et al. Effects of oral semaglutide on renal function in diabetic kidney disease: a short-term clinical study[J]. In Vivo, 2024,38(1):308-312.
[6] 陈雪吟,陈耿杭,杨丽虹,等. 糖尿病肾病湿热证与微炎症的相关性分析[J]. 广州中医药大学学报,2023,40(11):2689-2696.
[7] 白丽华,王小强,程晓亮. 黄葵胶囊联合来氟米特治疗IgA肾病湿热证疗效观察[J]. 现代中西医结合杂志,2017,26(24):2717-2719.
[8] 中华医学会糖尿病学分会微血管并发症学组. 糖尿病肾病防治专家共识(2014年版)[J]. 中华糖尿病杂志,2014,6(11):792-801.
[9] 中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2020年版)[J]. 中华内分泌代谢杂志,2021,37(4):311-398.
[10] GUI H, CHEN X, YE L, et al. Seven basement membrane-specific expressed genes are considered potential biomarkers for the diagnosis and treatment of diabetic nephropathy[J]. Acta Diabetol, 2023, 60(4):493-505.
[11] 曾桂桃,汤水福,程德金,等. 基于“肾虚络瘀”病机认识分期辨治糖尿病肾病[J]. 环球中医药,2021,14(3):433-436.[12] 韩宜臻,陶嘉菌,王珍,等. 王耀献基于“内热致癥”病机从三焦辨治糖尿病肾病[J]. 中医学报,2021,36(10):2142-2145.[13] 余凤娇,陈倩文. 司美格鲁肽联合替米沙坦治疗早期糖尿病肾病临床研究[J]. 中国药业,2023,32(13):99-102.
[14] 赵静,ISABELLE T,许陵冬,等. 黄葵胶囊治疗2型糖尿病肾脏病患者白蛋白尿疗效及安全性的临床研究[J]. 中华糖尿病杂志,2023,15(6):517-525.
[15] TANG G, LI S, ZHANG C, et al. Clinical efficacies, underlying mechanisms and molecular targets of Chinese medicines for diabetic nephropathy treatment and management[J]. Acta Pharm Sin B, 2021, 11(9):2749-2767.
[16] 罗钰凯,殷胜强,游晓蓉,等. 雷公藤多苷联合前列地尔对糖尿病肾病患者肾功能及炎症反应、免疫失衡的影响[J]. 山东医药,2022,62(20):81-84.
[17] FENG B, YANG F, LIU J, et al. Amelioration of diabetic kidney injury with dapagliflozin is associated with suppressing renal HMGB1 expression and restoring autophagy in obese mice[J]. J Diabetes Complications, 2023, 37(3):108409.
[18] 王丽娟,冯飞,周静波,等. 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[J]. 实用老年医学,2023,37(4):348-351.