Published online Sep 15, 2023. doi: 10.4239/wjd.v14.i9.1412
Peer-review started: July 4, 2023
First decision: July 19, 2023
Revised: July 27, 2023
Accepted: August 7, 2023
Article in press: August 7, 2023
Published online: September 15, 2023
Early diabetic nephropathy (DN) is a major complication of diabetes, a disease induced by glomerular sclerosis caused by a long-term glucose metabolism disorder. Progressive renal damage, edema, polyuria, and proteinuria are the main clinical symptoms of this disease. The main treatment plan comprising Western medicine for early DN is lipid-lowering and blood pressure regulation; however, the treatment effect is not good. Therefore, we used traditional Chinese medicine (TCM) to control disease progression from the root cause.
With the development of TCM, we already know that the main pathogenic mechanism of early DN is “Kidney deficiency and blood stasis, Qi and Yin insufficiency.” Therefore, we used western medicine combined with a TCM program for targeted treatment.
This study aimed to use sitagliptin tablets combined with Yiqi yangyin huoxue decoction to treat patients with early diabetic nephropathy, to observe the clinical efficacy and blood rheology in these patients, and to provide a basis for early clinical intervention to delay the progression of this disease.
Using a retrospective approach, patients with early DN were randomized into control group (CG) (n = 50) and observation group (OG) (n = 50). CG patients were treated with sitagliptin, and OG patients were treated with sitagliptin plus the Yiqi yangyin huoxue decoction. Both groups were treated for 3 mo.
The total response rate of the patients in the OG was 94.00%, and the total response rate of those in the CG was 80.00%. After treatment (T1), fasting blood glucose, 2 h postprandial glucose, total cholesterol, triacylglycerol, low-density lipoprotein cholesterol, cystatin C, homocysteine, urinary microalbumin, and blood creatinine levels in OG patients were markedly lower than those in the CG; further, red blood cell deposition, plasma viscosity, and hyperviscosity of whole blood in OG patients were markedly lower than those in the CG (all P < 0.05).
Sitagliptin combined with Yiqi yangyin huoxue decoction has achieved remarkable results in patients with early DN, helping to improve blood glucose, blood lipid, renal function, and hematological indicators.
In this retrospective study, patients with early DN were randomized into the CG and OG; the CG patients were treated with sitagliptin, and The OG patients were treated with sitagliptin plus Yiqi yangyin huoxue decoction; both groups were treated for 3 mo. Comparing the baseline data and clinical efficacy between the two groups, changes in blood glucose, blood lipid, renal function, and the hematology index were observed before (T0) and after treatment (T1). Thus, we explored the efficacy of sitagliptin in combination with Yiqi yangyin huoxue decoction for early DN treatment and its effect on blood rheology.