通心络胶囊联合非奈利酮治疗老年早期糖尿病肾病的临床研究

A clinical study on treatment of early diabetic nephropathy in the elderly with Tongxinluo capsules combined with finerenone

中文关键词: 老年  糖尿病肾病  非奈利酮  通心络胶囊  临床疗效  炎症

英文关键词: elderly  diabetic nephropathies  finerenone  Tongxinluo capsule  clinical efficacy  inflammation

中文摘要:

      目的 探讨通心络胶囊联合非奈利酮治疗老年早期糖尿病肾病(DKD)的临床疗效以及对血清炎症因子的影响情况.方法 选取2024 年1 月至2025 年6 月苏州市第九人民医院及苏州市吴江区第五人民医院84 例老年早期DKD 患者,根据随机数字表法将其分为对照组(n=42)和观察组(n=42).对照组患者给予非奈利酮治疗,观察组患者给予非奈利酮联合通心络胶囊治疗;2 组患者均接受持续12 周治疗.记录2 组患者的临床疗效及不良反应发生情况,比较2 组患者治疗前后血压、血糖、肾脏相关指标[血尿素氮(BUN)、估算肾小球滤过率(eGFR)、尿白蛋白与肌酐比值(UACR)]及血清炎性因子[超敏 C 反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平变化.结果 观察组总有效率高于对照组(P<0.05).治疗后2 组患者的 BUN、UACR、hs-CRP、IL-6、TNF-α 均较治疗前下降,且观察组下降幅度大于对照组;治疗后2 组患者的 eGFR 较治疗前升高,且观察组升高幅度大于对照组;差异均有统计学意义(P<0.05).2 组患者治疗过程中不良反应发生率差异无统计学意义(P>0.05).结论 通心络胶囊联合非奈利酮能提高老年早期 DKD 患者的临床疗效,改善血清炎症状态,且临床应用安全.

英文摘要:

      Objective To investigate the clinical efficacy of Tongxinluo capsule combined with finerenone in the treatment of elderly patients with early diabetic nephropathy and its effect on serum inflammatory factors.Methods A total of 84 elderly patients with early diabetic nephropathy treated in Ninth People's Hospital of Suzhou City and Fifth People's Hospital of Wujiang District from January 2024 to June 2025 were selected and randomly divided into control group(n=42)and observation group(n=42)using a random number table.The control group was treated with finerenone,while the observation group was treated with finerenone and Tongxinluo capsule.Both groups received continuous treatment for 12 weeks.The clinical efficacy and adverse reactions were recorded.The changes in blood pressure,blood glucose,renal-related indicators[blood urea nitrogen(BUN),estimated glomerular filtration rate(eGFR),urinary albumin-to-creatinine ratio(UACR)],and serum inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]were compared between the two groups before and after treatment.Results The total effective rate in the observation group was higher than that in the control group(P<0.05).After treatment,the levels of BUN,UACR,hs-CRP,IL-6 and TNF-α in both groups were lower than those in the same group before treatment,and the decreased range in the observation group was larger than that in the control group;the levels of eGFR in both groups were higher than those in the same group before treatment,and the increased range in the observation group was larger than that in the control group.All differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusion Tongxinluo capsule combined with finerenone can significantly improve clinical efficacy and serum inflammatory status in elderly patients with early diabetic nephropathy,and is safe for clinical application.