广西医学

目的探讨荆防当归补血汤联合非奈利酮治疗2型糖尿病肾病（T2DN）患者的临床疗效及对患者尿微量白蛋白（mALB）、尿转铁蛋白（UTF）水平的影响。方法将78例T2DN患者分为对照组和观察组，每组39例。给予对照组患者非奈利酮治疗，给予观察组患者荆防当归补血汤联合非奈利酮治疗，两组均治疗3个月。比较两组患者治疗后的临床疗效、治疗期间不良反应发生情况，以及治疗前及治疗3个月后的肾功能［血尿素氮（BUN）、mALB、UTF水平］、血糖［空腹血糖（FPG）、餐后2 h血糖（2hPBG）、HbA1c］水平、免疫功能［IgG、IgA、IgM水平］。结果治疗后，观察组的治疗总有效率高于对照组（P<0.05）。治疗后，两组患者的BUN、mALB、FPG、2hPBG及HbA1c水平低于治疗前，UTF、IgG、IgA水平高于治疗前，观察组的IgM水平高于治疗前，且观察组的BUN、mALB、FPG、2hPBG及HbA1c水平低于对照组，UTF、IgG、IgA及IgM水平高于对照组（P<0.05）。治疗期间，两组患者的不良反应发生率差异无统计学意义（P>0.05）。结论荆防当归补血汤联合非奈利酮治疗T2DN患者的临床疗效优于单独使用非奈利酮治疗，能有效改善T2DN患者的肾功能、血糖水平及免疫功能，且安全性较好。

Objective To investigate the clinical efficacy of Jingfang Danggui Buxue Decoction combined with finerenone for the treatment of patients with type 2 diabetic nephropathy (T2DN) and its effects on patients' microalbuminuria (mALB) and urinary transferrin (UTF) levels. Methods A total of 78 patients with T2DN were divided into control group or observation group, with 39 cases in each group. The control group received finerenone for treatment, while the observation group received Jingfang Danggui Buxue Decoction combined with finerenone for treatment. Both groups were treated for 3 months. Post⁃treatment clinical efficacy, occurrence status of adverse reactions during treatment, and pre⁃ and 3⁃month post⁃treatment renal function with respect to blood urea nitrogen (BUN), mALB, UTF levels, blood glucose levels in terms of fasting blood glucose (FPG), 2⁃hour postprandial blood glucose (2hPBG), HbA1c, and immune function (IgG, IgA, IgM levels) were compared between the two groups. Results After treatment, 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, mALB, FPG, 2hPBG, and HbA1c in both groups were lower than those before treatment, while the levels of UTF, IgG, and IgA were higher than those before treatment; furthermore, the obsearvation group exhibited a higher level of IgM as compared with before treatment. The levels of BUN, mALB, FPG, 2hPBG, and HbA1c in the observation group were lower than those in the control group, and the levels of UTF, IgG, IgA, and IgM were higher than those in the control group (P<0.05). There was no statistically significant difference in the incidence rate of adverse reactions between the two groups during treatment (P>0.05). Conclusion The clinical efficacy of Jingfang Danggui Buxue Decoction combined with finerenone in treating T2DN patients is superior to finerenone alone. It can effectively improve renal function, blood glucose levels, and immune function in T2DN patients, exerting good safety.