中国药物应用与监测

目的 探究恒格列净联合黄葵胶囊对糖尿病肾病(diabetic kidney disease,DKD)的疗效。方法 研究纳入皖西卫生职业学院附属医院2023年8月至2024年8月的108例DKD住院病例，采用抽签法分为对照组(n=54，采用基础治疗+口服黄葵胶囊)和观察组(n=54，在对照组基础上加用恒格列净)，比较两组患者临床疗效、治疗前后的血糖控制情况(餐后2 h血糖、糖化血红蛋白、空腹血糖)、肾功能指标(尿蛋白排泄率、血清肌酐)、炎症因子(C反应蛋白、白细胞介素6)水平以及不良反应发生情况。结果 治疗后，观察组和对照组的总有效率分别为90.75%(49/54)和75.93%(41/54)(χ²=4.267,P<0.05)；糖化血红蛋白[(6.35±0.84)%vs(7.45±0.83)%]、餐后2 h血糖[(8.26±0.74)mmol/L vs(9.65±0.73)mmol/L]和空腹血糖[(5.51±0.75)mmol/L vs(6.05±0.73)mmol/L]差异均有统计学意义(t=6.845、9.120、3.791，均P<0.05)；尿蛋白排泄率[(98.65±11.35)mg/24 h vs(114.35±11.32)mg/24 h]和血清肌酐[(94.53±13.52)μmol/L vs(105.35±12.32)μmol/L]差异均有统计学意义(t=7.197、4.347，均P<0.05);C反应蛋白[(2.54±0.51)mg/L vs(3.45±0.53)mg/L]和白细胞介素6[(8.56±1.54)pg/mL vs(11.35±1.52)pg/mL]差异均有统计学意义(t=9.092、9.475，均P<0.05)；观察组和对照组的不良反应发生率[(7.41%(4/54) vs 3.70%(2/54)]差异无统计学意义(χ²=0.706,P>0.05)。结论 恒格列净联合黄葵胶囊治疗DKD患者，能够提高临床疗效，降低血糖水平，改善肾功能和炎症反应，且安全性较好。

Objective To explore the therapeutic effect of henagliflozin combined with Huangkui capsules on diabetic kidney disease(DKD). Methods A total of 108 inpatients with DKD admitted to the Affiliated Hospital of Western Anhui Health Vocational College from August 2023 to August 2024 were enrolled in the study and divided into the control group(n=54, oral administration of Huangkui capsules on top of standard therapy) and the observation group(n=54, received henagliflozin in addition to the control group regimen) by the lottery method. The clinical efficacy, blood glucose control(2-hour postprandial glucose(2 hPG), glycated hemoglobin(HbA_1c), fasting plasma glucose(FPG)), renal function indicators(urinary albumin excretion rate(UAER), serum creatinine(Scr)), inflammatory factors(C-reactive protein(CRP), interleukin-6(IL-6)) and adverse reactions were compared between the two groups before and after treatment. Results After treatment, the total effective rates of the observation group and the control group were 90.75%(49/54) and 75.93%(41/54), respectively(χ²=4.267, P<0.05). The differences in glycated hemoglobin((6.35±0.84)% vs(7.45±0.83)%), 2 hPG((8.26±0.74) mmol/L vs(9.65±0.73) mmol/L) and fasting blood glucose((5.51±0.75) mmol/L vs(6.05±0.73) mmol/L) between the observation group and the control group were all statistically significant(t=6.845, 9.120, 3.791, all P<0.05). Similarly, the differences in UAER((98.65±11.35) mg/24 h vs(114.35±11.32) mg/24 h) and Scr((94.53±13.52) μmol/L vs(105.35±12.32) μmol/L) between the two groups were statistically significant(t=7.197, 4.347, both P<0.05). Furthermore, the differences in CRP((2.54±0.51) mg/L vs(3.45±0.53) mg/L) and IL-6((8.56±1.54) pg/mL vs(11.35±1.52) pg/mL) between the two groups were also statistically significant(t=9.092, 9.475, both P<0.05). The incidence rates of adverse reactions showed no statistically significant difference between the observation group and the control group(7.41%(4/54) vs 3.70%(2/54))(χ²=0.706, P>0.05). Conclusion Huangkui capsules combined with henagliflozin for DKD patients can enhance the clinical efficacy, reduce the blood glucose, and improve the renal function and inflammatory response, with good safety.