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雷公藤多苷联合非奈利酮治疗糖尿病肾病的有效性与安全性
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| 篇名： | 雷公藤多苷联合非奈利酮治疗糖尿病肾病的有效性与安全性 |
| TITLE： | Efficacy and safety of Tripterygium wilfordii polyglycoside combined with finerenone in the treatment of diabetic nephropathy |
| 摘要： | 目的 探究雷公藤多苷联合非奈利酮治疗糖尿病肾病（DN）患者的有效性与安全性。方法选取2023年1月至2024年5月邯郸市中心医院肾内科收治的104例DN患者为研究对象，随机分为对照组（52例）和联合组（52例）。所有患者均接受降血脂、血糖等基础治疗，对照组患者在此基础上给予非奈利酮治疗，联合组患者给予雷公藤多苷联合非奈利酮治疗，两组患者均治疗3个月。比较两组患者的临床疗效、治疗前后的肾功能指标[24h尿蛋白定量（24hUPE）、尿白蛋白与肌酐比值（UACR）、尿白蛋白排泄率（UAER）]、炎症因子[高迁移率族蛋白B1（HMGB1）、白细胞介素6（IL-6）、核因子κB（NF-κB）、超敏C反应蛋白（hs-CRP）]和氧化应激指标[总抗氧化能力（T-AOC）、超氧化物歧化酶（SOD）、晚期氧化蛋白产物（AOPP）、丙二醛（MDA）]，记录不良反应发生情况。结果在有效性方面，联合组患者的治疗总有效率显著高于对照组（P＜0.05）；治疗后，两组患者的24hUPE、UACR、UAER、HMGB1、IL-6、NF-κB、hs-CRP、AOPP、MDA均显著低于同组治疗前，两组患者的T-AOC、SOD均显著高于同组治疗前，且联合组以上指标变化优于同期对照组（P＜0.05）。在安全性方面，两组患者的不良反应总发生率比较，差异无统计学意义（P＞0.05）。结论相较于非奈利酮单药治疗，雷公藤多苷联合非奈利酮治疗DN的疗效显著，能降低患者的蛋白尿水平，减轻炎症反应，缓解氧化应激，且未增加不良反应的发生风险。 |
| ABSTRACT： | OBJECTIVE To explore the efficacy and safe ty of Tripterygium wilfordii polyglycoside combined with finerenone in the treatment of diabetic nephropathy （DN）. METHODS This study selected 104 DN patients admitted to the Nephrology Department of Handan Central Hospital from January 2023 to May 2024 as the subjects and randomly assigned them into the control group （52 cases） and the combination group （52 cases）. All patients received basic treatment such as lipid-lowering and blood glucose control. On this basis， patients in the control group received finerenone， while those in the combination group received a combination therapy of T. wilfordii polyglycoside and finerenone. Both groups underwent treatment for a duration of three months. The two groups were compared in terms of clinical efficacy， renal function indicators [24-hour urine protein excretion （24 h UPE）， urinary albumin-to-creatinine ratio （UACR）， urinary albumin excretion rate （UAER） ] ， inflammatory factors [high mobility group box 1 protein （HMGB1）， interleukin-6 （IL-6）， nuclear factor-κB （NF-κB）， high-sensitivity C reactive protein （hs-CRP） ] ， and oxidative stress indicators [total antioxidant capacity （T-AOC）， superoxide dismutase （SOD）， advanced oxidation protein products （AOPP）， malondialdehyde （MDA） ] before and after treatment. Additionally， the occurrence of adverse drug reactions was recorded. RESULTS In terms of efficacy， the total effective rate of patients in the combination group was higher than that of the control group （ P ＜0.05）. After treatment， the levels of 24-h UPE， UACR， UAER， HMGB1， IL-6， NF-κB， hs-CRP， AOPP and MDA in the two groups were significantly lower than those in the same group before treatment； the levels of T-AOC and SOD in the two groups were significantly higher than those in the same group before treatment， with the combination group showing superior changes in the above indicators compared to the control group at the corresponding time point （ P ＜0.05）. In terms of safety， there was no statistical significance in the total incidence of adverse drug reactions between the two groups （ P ＞0.05）. CONCLUSIONS Compared to finerenone monotherapy， the combination therapy of T. wilfordii polyglycoside and finerenone demonstrates significant efficacy in treating DN. It effectively reduces proteinuria levels， alleviates inflammatory reaction， mitigates oxidative stress， and does not increase the risk of adverse reactions. |
| 期刊： | 2026年第37卷第04期 |
| 作者： | 赵新成；李瑞民；崔书霞 |
| AUTHORS： | ZHAO Xincheng，LI Ruimin，CUI Shuxia |
| 关键字： | 雷公藤多苷；非奈利酮；糖尿病肾病；蛋白尿；炎症反应；氧化应激；安全性 |
| KEYWORDS： | Tripterygium wilfordii polyglycoside； finerenone； |
| 阅读数： | 2 次 |
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