2023 年第 10 期 第 18 卷

木丹颗粒联合胰激肽原酶治疗气虚血瘀型早期糖尿病肾病的临床效果

Clinical efficacy of Mudan granules combined with pancreatic kininogenase in the treatment of early diabetic nephropathy of Qi deficiency and blood stasis type

作者：王帅1王丽2于世家2

英文作者：Wang Shuai1 Wang Li2 Yu Shijia2

单位：1辽宁中医药大学研究生学院，沈阳110031；2辽宁中医药大学附属医院内分泌科，沈阳110031

英文单位：1Graduate School of Liaoning University of Traditional Chinese Medicine Shenyang 110031 China; 2Department of Endocrinology Affiliated Hospital of Liaoning University of Traditional Chinese Medicine Shenyang 110031 China

关键词：早期糖尿病肾病；木丹颗粒；胰激肽原酶；气虚血瘀

英文关键词：Earlydiabeticnephropathy;Mudangranules;Pancreatickininogenase;Qideficiencyandbloodstasis

• 摘要：

• 目的  探讨木丹颗粒联合胰激肽原酶治疗气虚血瘀型早期糖尿病肾病（DN）的临床效果。方法  选取2021年4月至2022年5月辽宁中医药大学附属医院收治的100例气虚血瘀型早期DN患者，采用随机数字表法分为对照组、观察组，各50例。所有患者均采用常规降糖药物方案、干预生活方式等治疗，对照组在常规治疗基础上予胰激肽原酶肠溶片口服治疗，观察组在对照组基础上予木丹颗粒口服治疗。2组均连续治疗4周。比较2组临床疗效以及治疗前后血清炎性因子指标、肾功能以及胰岛功能指标水平。结果  治疗4周后，观察组总有效率高于对照组［92.0%（46/50）比72.0%（36/50）］（P=0.032）。治疗4周后，2组血清高敏C反应蛋白、肿瘤坏死因子α、白细胞介素6、胱抑素C、β2微球蛋白、空腹胰岛素水平和尿白蛋白/肌酐比值、稳态模型胰岛素抵抗指数均低于治疗前、且观察组均低于对照组，估算肾小球滤过率、稳态模型胰岛β细胞功能指数均高于治疗前、且观察组均高于对照组［（84±8）ml/（min·1.73 m2）比（71±9）ml/（min·1.73 m2）、（104±6）比（89±5）］（均P＜0.05）。结论  木丹颗粒联合胰激肽原酶治疗气虚血瘀型早期DN有良好的临床效果，同时对于缓解肾脏炎性反应、修复肾脏损伤及改善胰岛功能有较好的作用。

• Objective  To investigate the clinical efficacy of Mudan granules combined with pancreatic kininogenase in the treatment of early diabetic nephropathy (DN) of Qi deficiency and blood stasis type. Methods  From April 2021 to May 2022, 100 patients with early DN of Qi deficiency and blood stasis type who were admitted to Affiliated Hospital of Liaoning University of Traditional Chinese Medicine were selected. They were divided into control group and observation group using the random number table method, with 50 cases in each group. All patients were treated with routine hypoglycemic drug regimens and lifestyle interventions. The control group was treated with pancreatic kininogenase enteric-coated tablets orally on the basis of the routine treatment, and the observation group was treated with Mudan granules orally on the basis of the control group. Both groups were treated continuously for 4 weeks. The clinical efficacy, the levels of serum inflammatory factors indexes, renal function and pancreatic islet function indexes were compared between the two groups before and after treatment. Results  After 4 weeks of treatment, the overall effective rate of the observation group was higher than that of the control group［92.0%（46/50） vs 72.0%（36/50）］（P=0.032）. After 4 weeks of treatment, the levels of serum high-sensitivity C-reactive protein, tumor necrosis factor α, interleukin-6, cystatin C, β2-microglobulin, fasting insulin, urine albumin/creatinine ratio and the steady-state model′s insulin resistance index were lower than those before treatment, and the observation group were lower than the control group. The estimated glomerular filtration rate and the steady-state model′s pancreatic β cell function index were higher than those before treatment, and the observation group were higher than the control group ［（84±8）ml/（min·1.73 m2） vs （71±9）ml/（min·1.73 m2），（104±6） vs （89±5）］(all P＜0.05). ConclusionsMudan granules combined with pancreatic kininogenase have shown good clinical efficacy in the treatment of early DN of Qi deficiency and blood stasis type, and also significantly alleviates renal inflammatory responses, repairs renal injury, and improves pancreatic islet function.