目的 基于改善患者腎功能、血液流變學(xué)角度，探討參烏益腎片聯(lián)用達(dá)格列凈治療氣陰兩虛血瘀型糖尿病腎?。―N）患者的療效。方法 選擇六安市中醫(yī)院2024年1月—2025年4月期間收治的DN患者98例進(jìn)行前瞻性研究，采用隨機(jī)數(shù)字表法分為對照組和治療組，每組49例患者，兩組均行常規(guī)治療，在此基礎(chǔ)上，對照組口服達(dá)格列凈片，每次1片，每天1次，治療組在對照組基礎(chǔ)上聯(lián)用參烏益腎片，口服，每次4片，每天3次。兩組均治療4周。比較兩組治療總有效率，測定治療前后兩組患者中醫(yī)證候積分（水腫、夜尿頻多、乏力、肢體酸軟、內(nèi)心煩熱），腎功能指標(biāo)，血液流變學(xué)指標(biāo)，血糖指標(biāo)和胰島素功能指標(biāo)，觀察治療期間的用藥安全性。結(jié)果 治療組總有效率為93.88%，明顯高于對照組的總有效率（79.59%,P<0.05）。治療前，兩組患者中醫(yī)證候積分、腎功能指標(biāo)、血液流變學(xué)指標(biāo)、血糖指標(biāo)和胰島功能各項指標(biāo)比較，差異均不顯著（P>0.05）；治療后，兩組患者中醫(yī)證候積分均顯著下降，腎功能、血液流變學(xué)指標(biāo)、血糖指標(biāo)和胰島素功能指標(biāo)均得到有效改善（P<0.05）；與對照組比較，治療后治療組中醫(yī)證候積分更低，血液流變學(xué)、血糖水平與胰島素抵抗程度均改善得更顯著（P<0.05）。治療組不良反應(yīng)發(fā)生率略高，但組間比較，差異不顯著（P>0.05）。結(jié)論 參烏益腎片聯(lián)用達(dá)格列凈治療氣陰兩虛血瘀型DN患者，能夠有效緩解患者的臨床癥狀，對控制患者血糖水平、改善腎功能、改善血液流變學(xué)指標(biāo)均具有積極作用，且安全性較高，具有臨床推廣應(yīng)用價值。

Objective To investigate the efficacy of Shenwu Yishen Tablets combined with Dapagliflozin Tablets in treating diabetic nephropathy（DN） patients with the pattern of qi-yin deficiency and blood stasis, focusing on improvements in renal function and hemorheology. Methods A prospective study was conducted on 98 DN patients admitted to Lu’an Hospital of Traditional Chinese Medicine from January 2024 to April 2025. The patients were randomly divided into a control group and a treatment group using a random number table, with 49 patients in each group. Both groups received conventional treatment. In addition, the control group was administered Dapagliflozin Tablets orally（one tablet once daily）, while the treatment group received an additional combination of Shenwu Yishen Tablets orally（four tablets, three times daily）. The treatment duration for both groups was four weeks. The total effective rate was compared between the two groups. Traditional Chinese medicine（TCM） syndrome scores（edema, frequent nocturia, fatigue, limb soreness, and internal heat）, renal function indicators, hemorheological parameters, blood glucose levels, and pancreatic β-cell function were measured before and after treatment. The safety of the treatment was also observed. Results The total effective rate in the treatment group（93.88%） was significantly higher than that in the control group（79.59%, P＜0.05）. Before treatment, there were no significant differences in TCM syndrome scores, renal function indicators, hemorheological parameters, blood glucose levels, or pancreatic β-cell function between the two groups（P＞0.05）. After treatment, both groups showed significant reductions in TCM syndrome scores and improvements in renal function, hemorheological parameters, and blood glucose levels（P＜0.05）. Compared with the control group, the treatment group exhibited significantly lower TCM syndrome scores, greater improvements in hemorheology, blood glucose levels, and insulin resistance（P＜0.05）. The incidence of adverse reactions was slightly higher in the treatment group, but the difference was not statistically significant（P＞0.05）. Conclusion The combination of Shenwu Yishen Tablets and Dapagliflozin Tablets effectively alleviates clinical symptoms, helps control blood glucose levels, improves renal function and hemorheological parameters, and demonstrates high safety in treating DN patients with the pattern of qi-yin deficiency and blood stasis. This combination therapy holds clinical value for broader application.

R977