钠-葡萄糖协同转运蛋白2抑制剂联合金匮肾气丸对Ⅲ、Ⅳ期糖尿病肾病的应用效果研究OA
Study on the efficacy of SGLT-2 inhibitors combined with Jinkui Shenqi Pill in patients with stage Ⅲ-Ⅳ diabetic kidney disease
目的 评估在标准降糖及肾脏保护方案基础上加用金匮肾气丸,对Ⅲ、Ⅳ期糖尿病肾病患者肾功能、氧化-炎症状态及生活质量的影响和安全性.方法 回顾性选取2022年2月—2025年2月大庆市龙南医院126例Ⅲ、Ⅳ期糖尿病肾病患者为研究对象,均接受常规标准降糖治疗,对照组(63例)接受钠-葡萄糖协同转运蛋白2抑制剂(SGLT-2I),观察组(63例)在对照组基础上加用金匮肾气丸.比较两组患者治疗前后的肾小球滤过率(eGFR)、尿白蛋白/肌酐比值(UACR)、24h尿白蛋白排泄率(AER)、肾小球-肾小管功能指标[尿总蛋白/肌酐比(uTP/Cr)、肾损伤分子-1(KIM-1)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、N-乙酰-β-D-葡萄糖苷酶(NAG)]、氧化应激与炎症指标[超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)]、血糖指标[糖化血红蛋白(HbA1c)、空腹血糖(FPG)]、肾脏疾病生活质量(KDQOL-36)评分,以及不良事件.结果 两组治疗第8周,观察组eGFR高于对照组,UACR、24h AER均低于对照组(P<0.05);观察组uTP/Cr、尿KIM-1、尿NGAL、尿NAG均低于对照组(P<0.05);观察组SOD、GSH-Px均高于对照组,血浆MDA、尿MDA均低于对照组(P<0.05).观察组治疗前后HbA1c、FPG差值均高于对照组(P<0.05).观察组KDQOL-36评分各维度均高于对照组(P<0.05).观察组患者不良事件总发生率低于对照组(P<0.05).结论 在SGLT-2I基础上联合金匮肾气丸,能显著减缓Ⅲ、Ⅳ期糖尿病肾病患者肾功能衰退,降低蛋白尿与肾小管损伤,改善氧化-炎症状态与生活质量,减少总体不良反应.
Objective To evaluate the effects and safety of adding Jinkui Shenqi Pill to standard hypoglycemic and renal protection regimens on renal function,oxidative-inflammatory status,and quality of life in patients with stage Ⅲ-Ⅳ diabetic kidney disease(DKD).Methods A total of 126 patients with stage Ⅲ-Ⅳ DKD treated in Longnan Hospital of Daqing from February 2022 to February 2025 were retrospectively enrolled.All patients received routine standard hypoglycemic treatment.The control group(63 cases)received sodium-glucose cotransporter 2 inhibitors(SGLT-2I),and the observation group(63 cases)received additional Jinkui Shenqi Pill on the basis of the control group.The estimated glomerular filtration rate(eGFR),urine albumin-creatinine ratio(UACR),24-hour urinary albumin excretion rate(AER),glomerular-tubular function indexes(urine total protein/creatinine ratio,kidney injury molecule-1[KIM-1],neutrophil gelatinase-associated lipocalin[NGAL],N-acetyl-β-D-glucosaminidase[NAG]),oxidative stress indicators(superoxide dismutase[SOD],glutathione peroxidase[GSH-Px],malondialdehyde[MDA]),Kidney Disease Quality of Life(KDQOL-36)scores,glycemic indicators(glycated hemoglobin[HbA1c],fasting plasma glucose[FPG]),and adverse events were compared between the two groups before and after treatment.Results After 8 weeks of treatment,the observation group had higher eGFR,and lower UACR and 24h AER than the control group(P<0.05).Urine total protein/creatinine ratio,urinary KIM-1,NGAL and NAG were lower in the observation group(P<0.05).SOD and GSH-Px were higher,while plasma MDA and urinary MDA were lower in the observation group(P<0.05).The pre-to-post-treatment reductions in HbA1c and FPG were greater in the observation group than in the control group(P<0.05).All dimensions of KDQOL-36 scores were higher in the observation group(P<0.05).The total incidence of adverse events was lower in the observation group(P<0.05).Conclusion Combining Jinkui Shenqi Pill with SGLT-2 inhibitors significantly slows renal function decline,reduces proteinuria and tubular injury,improves oxidative-inflammatory status and quality of life,and lowers overall adverse events in stage Ⅲ-Ⅳ DKD patients.
贾晶;孙美娜
大庆市龙南医院 肾内科,黑龙江 大庆 163000大庆市龙南医院 肾内科,黑龙江 大庆 163000
医药卫生
糖尿病肾病钠-葡萄糖协同转运蛋白2抑制剂金匮肾气丸肾功能不良反应
diabetic kidney diseaseSGLT-2 inhibitorsJinkui Shenqi Pillrenal functionadverse reactions
《中国现代医学杂志》 2026 (11)
24-30,7
黑龙江省自然科学计划项目(2024XE0269)
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