目的 基于改善患者肾功能、血液流变学角度，探讨参乌益肾片联用达格列净治疗气阴两虚血瘀型糖尿病肾病（DN）患者的疗效。方法 选择六安市中医院2024年1月—2025年4月期间收治的DN患者98例进行前瞻性研究，采用随机数字表法分为对照组和治疗组，每组49例患者，两组均行常规治疗，在此基础上，对照组口服达格列净片，每次1片，每天1次，治疗组在对照组基础上联用参乌益肾片，口服，每次4片，每天3次。两组均治疗4周。比较两组治疗总有效率，测定治疗前后两组患者中医证候积分（水肿、夜尿频多、乏力、肢体酸软、内心烦热），肾功能指标，血液流变学指标，血糖指标和胰岛素功能指标，观察治疗期间的用药安全性。结果 治疗组总有效率为93.88%，明显高于对照组的总有效率（79.59%,P<0.05）。治疗前，两组患者中医证候积分、肾功能指标、血液流变学指标、血糖指标和胰岛功能各项指标比较，差异均不显著（P>0.05）；治疗后，两组患者中医证候积分均显著下降，肾功能、血液流变学指标、血糖指标和胰岛素功能指标均得到有效改善（P<0.05）；与对照组比较，治疗后治疗组中医证候积分更低，血液流变学、血糖水平与胰岛素抵抗程度均改善得更显著（P<0.05）。治疗组不良反应发生率略高，但组间比较，差异不显著（P>0.05）。结论 参乌益肾片联用达格列净治疗气阴两虚血瘀型DN患者，能够有效缓解患者的临床症状，对控制患者血糖水平、改善肾功能、改善血液流变学指标均具有积极作用，且安全性较高，具有临床推广应用价值。

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