2024 年第 10 期 第 0 卷

益肾化湿颗粒联合司美格鲁肽治疗糖尿病肾病的临床效果及对患者微炎症状态的影响

Clinical effect of Yishen Huashi granule combined with semaglutide in the treatment of diabetic nephropathy and its effect on microinflammatory state of patients

作者：李建军闫俊慧孙迎春刘育硕杨再波

英文作者：Li Jianjun Yan Junhui Sun Yingchun Liu Yushuo Yang Zaibo

单位：北京大学第三医院秦皇岛医院肾内科，秦皇岛066000

英文单位：Department of Nephrology Peking University Third Hospital Qinhuangdao Hospital Qinhuangdao 066000 China

关键词：糖尿病肾病；益肾化湿颗粒；司美格鲁肽；微炎症状态

英文关键词：Diabeticnephropathy;YishenHuashigranule;Semaglutide;Microinflammatorystate

• 摘要：

• 目的 探讨益肾化湿颗粒联合司美格鲁肽治疗糖尿病肾病（DN）的效果及对患者微炎症状态的影响。方法 选取2022年1月至2023年12月北京大学第三医院秦皇岛医院收治的220例DN患者为研究对象。按照随机数字表法分为司美格鲁肽组和联合组，各110例。司美格鲁肽组在常规治疗的基础上给予司美格鲁肽注射液皮下注射治疗，联合组在司美格鲁肽组基础上加用益肾化湿颗粒口服治疗。比较2组疗效、糖脂代谢、肾功能、氧化应激、微炎症状态指标及不良反应发生情况。结果联合组总有效率高于司美格鲁肽组［93.6%（103/110）比83.6%（92/110）］（P=0.019）。治疗后，2组空腹血糖、餐后2 h血糖、糖化血红蛋白、总胆固醇、低密度脂蛋白胆固醇、血肌酐、β2微球蛋白、24 h尿蛋白定量、丙二醛、高敏C反应蛋白、肿瘤坏死因子α及白细胞介素6水平均低于治疗前且联合组均低于司美格鲁肽组，高密度脂蛋白胆固醇、谷胱甘肽过氧化物酶、超氧化物歧化酶水平均高于治疗前且联合组高于司美格鲁肽组（均P＜0.05）。2组不良反应总发生率差异无统计学意义（P=0.604）。结论 益肾化湿颗粒联合司美格鲁肽治疗DN效果优于单一采用司美格鲁肽，可有效降低患者血糖血脂水平，改善微炎症状态，且安全性良好。

• Objective To investigate the effect of Yishen Huashi granule combined with semaglutide in the treatment of diabetic nephropathy (DN) and its effect on microinflammatory state of patients. Methods A total of 220 DN patients admitted to Peking University Third Hospital Qinhuangdao Hospital from January 2022 to December 2023 were selected as the research objects. According to the random number table method, they were divided into semaglutide group and combination group, with 110 cases in each group. The semaglutide group was treated with subcutaneous injection of semaglutide injection on the basis of conventional treatment, and the combined group was treated with Yishen Huashi granule on the basis of semaglutide group. The efficacy, glucose and lipid metabolism, renal function, oxidative stress, microinflammatory state indicators and adverse reactions were compared between the two groups. Results The total effective rate of the combination group was higher than that of the semaglutide group ［93.6%(103/110) vs 83.6%(92/110)］(P=0.019). After treatment, the levels of fasting blood glucose, 2 h postprandial blood glucose, glycosylated hemoglobin, total cholesterol, low-density lipoprotein cholesterol, serum creatinine, β2-microglobulin, 24 h urinary protein, malondialdehyde, high-sensitivity C-reactive protein, tumor necrosis factor-α and interleukin-6 in the two groups were lower than those before treatment, and those in the combination group were lower than those in the semaglutide group; the levels of high-density lipoprotein cholesterol, glutathione peroxidase and superoxide dismutase were higher than those before treatment, and those in combination group were higher than those in semaglutide group (all P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P=0.604). Conclusion Yishen Huashi granule combined with semaglutide is superior to semaglutide alone in the treatment of DN, which can effectively reduce blood glucose and lipid levels of patients, improve micro-inflammatory state, and has good safety.