| 叶淑菁,李玉卿.非奈利酮联合金匮肾气汤加减治疗2型糖尿病伴慢性肾脏病临床研究[J].浙江中西医结合杂志,2025,35(6): |
| 非奈利酮联合金匮肾气汤加减治疗2型糖尿病伴慢性肾脏病临床研究 |
| Clinical?Study?on?the?Treatment?of?Type?2?Diabetes?Mellitus?with?Chronic?Kidney?Disease?Using?Finerenone?Combined?with?Modified?Jin?Gui?Shen?Qi?Decoction |
| 投稿时间：2024-11-28 修订日期：2025-03-09 |
| DOI： |
| 中文关键词: 非奈利酮 金匮肾气汤加减 2型糖尿病 慢性肾脏病 尿白蛋白/肌酐比值 安全性 |
| 英文关键词:Finerenone, Jin?Gui?Shen?Qi?decoction, Type 2 diabetes mellitus, Chronic kidney disease, Urinary albumin/creatinine ratio, Safety |
| 基金项目:]浙江省嘉兴市科技计划项目(编号:2023A70) |
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| 中文摘要: |
| 目的：观察非奈利酮联合金匮肾气汤加减治疗2型糖尿病（T2DM）伴慢性肾脏病（CKD）的临床疗效及安全性。方法：选取60例T2DM伴CKD患者为研究对象，采用随机数字表法分为实验组和对照组各30例，两组均给予非奈利酮及西医常规治疗，实验组在此基础上联合金匮肾气汤加减，治疗12周，观察治疗前、治疗后的临床疗效、中医症状积分、尿蛋白、肾功能及血钾等指标。结果：治疗后，实验组总有效率(93.33%)高于对照组(73.33%),差异有统计学意义（P<0.05）；两组治疗后的各项中医症状积分及总积分均低于治疗前（P<0.05），且实验组优于对照组（P<0.05）；两组治疗后的尿白蛋白/肌酐比值、24h尿蛋白定量均低于治疗前，且实验组水平更低（P<0.05）；与治疗前相比，治疗4周时两组血肌酐上升、肾小球滤过率下降（P均<0.05），继续治疗至12周时，两组的血肌酐下降、肾小球滤过率上升（P均<0.05）；治疗后两组的血钾水平均较前上升（P<0.05），均为轻中度升高，无严重高钾血症；两组治疗前后血压、血尿酸水平差异无统计学意义（P>0.05）。结论：非奈利酮联合金匮肾气汤加减治疗T2DM伴CKD疗效确切，且安全性可，在临床上值得推广应用。 |
| 英文摘要: |
| Objective: To make the observation of the clinical efficacy and safety of finerenone combined with modified?Jin?Gui?Shen?Qi?decoction in the treatment of type 2 diabetes mellitus (T2DM) with chronic kidney disease (CKD). Methods: Sixty patients with T2DM and CKD were chosen as the research subjects and randomly divided into an experimental group and a control group, each consisting of 30 cases. Finerenone and conventional Western medicine treatment were administered to both groups.Additionally, the experimental group received modified?Jin?Gui?Shen?Qi?decoction. The treatment spanned 12 weeks, during which clinical efficacy, traditional Chinese medicine (TCM) symptom scores, urinary protein levels, renal function, and serum potassium levels were observed before and after the treatment period. Results: After the treatment period, it was observed that the total effective rate in the experimental group (93.33%) surpassed that of the control group (73.33%), with the difference being statistically significant (P<0.05). The TCM symptom scores and total scores for both groups post-treatment were reduced compared to their pre-treatment levels (P<0.05), with the experimental group demonstrating superior outcomes to the control group (P<0.05). The urinary albumin/creatinine ratio (UACR) and 24-hour urine protein quantification levels for both groups decreased post-treatment relative to their pre-treatment values, with the experimental group exhibiting lower levels (P<0.05). In comparison to the pre-treatment period, at 4 weeks into the treatment, both groups experienced an increase in serum creatinine (Scr) and a decrease in estimated glomerular filtration rate (eGFR) (P<0.05 for both), but by the 12th week of continued treatment, the Scr levels for both groups had decreased and the eGFR had increased (P<0.05 for both). Post-treatment serum potassium levels for both groups were elevated compared to their pre-treatment levels (P<0.05), all of which were mild to moderate increases, and no serious hyperkalemia adverse events were recorded. No statistically significant differences were found in blood pressure and serum uric acid levels before and after treatment for both groups (P>0.05). Conclusion: The effectiveness of finerenone combined with modified?Jin?Gui?Shen?Qi?decoction in the treatment of T2DM with CKD has been demonstrated, with patients' symptoms being effectively alleviated, urinary protein levels reduced, renal function improved, and the treatment shown to be safe. Therefore, it is considered worthy of clinical application and promotion. |
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