达格列净联合百令胶囊治疗糖尿病肾病患者的有效性及安全性评价

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[中图分类号] R587.24 [文献标志码] A

Efficacy and safety of dapagliflozin combined with Bailing Capsule in treatment of patients with diabetic kidney diseaseSUI Yingying， ZHOU Quan，HAN Yafei，SUN Jialin，HAN Zhiou（Scholof Basic Medicine， Qingdao University，Qingdao ，China）

[ABSTRACT]ObjectiveToinvestigate theeficacyand safetyof dapagliflozincombined withBailing Capsule inthe treatmentof patients withdiabetic kidneydisease（DKD）.MethodsAtotalof1162patients with early-stageDKDwho wereadmittedtoTheAfiliatedHospitalofQingdaoUniversityfromJanuary0l9toDecember223wereenrolld，andafterpropensityscore matching was performed tobalanceintergroupcovariates，thepatientsweredividedintocontrolgroup（dapaglfozin monotherapy） and combination group （dapagliflozin + Bailing Capsule） according to their treatment modality，with 417 patients in each group. Thetwo groups werecomparedintermsofclinicaloutcome，blood glucose parameters，renalfunctionparameters，safetyindicators （liverfunctionandroutine bloodtestresults），andtheincidencerateofadverseeventsafter12 monthsof treatment. ResultsAfter12 monthsof treatment，thecombinationgrouphadasignificantlybeterclinicaloutcomethanthecontrolgroup 0 ⋅Z=2.919，P<0.05） ; the combination group had reductions in the levels of fasting plasma glucose，2 hour postprandial glucose， and HbAlc aftertreatment，with significantly greater reductions in these indicators compared withthe control group ⋅t=41.91- （20 59.57，P<0.05） .The combination group had significant reductions in serum creatinine，blood urea nitrogen，24 hour urinary protein，andurinaryalbuminexcretionrateaftertreatment，withsignificantlygreaterreductionsintheseindicatorscompared withthe control group （t=12.51-154.9，P<0.05） .After l2 months of treatment，liver function parameters and routine blood test results remainedwithinnormalrangesinothgroups，andtherewerenosignificantdiferencesbetweenthetwogroupsintheincidence rates of adverse events such as hypoglycemia and urinary tract infection （ P>0.05） .ConclusionDapagliflozin combined with Bailing Capsulecansignificantlyreduce thelevelofblood glucoseandimproverenalfunctionparameters inpatients withDKD，with a better clinical effect than dapagliflozin monotherapy and with a favorable safety profile.

[KEYWORDs]Diabeticnephropathies；Integratedchinese traditionaland westernmedicinetherapy；Sodium-glucose transporter 2 inhibitors； Bailing Capsule；Propensity score；Treatment outcome；Dapagliflozin

糖尿病肾病（diabetickidneydisease，DKD）是常见的糖尿病微血管病变，约 30%～40% 糖尿病患者最终进展为DKD，是终末期肾病的主要病因[1]研究发现，高血糖状态下时钠-葡萄糖共转运蛋白2（SGLT-2）在肾小管中的表达上调，可致肾小管对原尿中葡萄糖的重吸收增加，加重肾脏的代谢负荷，长时间可导致肾脏损伤[2]。（剩余8464字）