目的 研究腎衰寧膠囊聯(lián)合坎地沙坦酯片治療糖尿病腎病的臨床療效。方法 選取2018年12月-2019年12月鄭州市金水區(qū)總醫(yī)院收治的65例糖尿病腎病患者，將所有患者隨機(jī)分為對(duì)照組（32例）和治療組（33例）。對(duì)照組患者口服坎地沙坦酯片，1片/次，1次/d。治療組在對(duì)照組基礎(chǔ)上口服腎衰寧膠囊，4粒/次，3次/d。兩組患者持續(xù)治療30 d。觀察兩組患者臨床療效，比較兩組的腎功能指標(biāo)、血糖水平、血清炎性因子水平、氧化應(yīng)激指標(biāo)。結(jié)果 治療后，對(duì)照組和治療組患者的總有效率分別為81.25%、93.94%，治療組的臨床療效顯著高于對(duì)照組（P<0.05）。治療后，兩組24 h尿蛋白定量、尿素氮（BUN）、尿白蛋白排泄率（UAER）、血肌酐（Scr）水平均顯著降低（P<0.05）；并且治療組腎功能指標(biāo)改善較明顯（P<0.05）。治療后，兩組血清空腹血糖（FPG）和糖化血紅蛋白（HbA1c）水平顯著降低（P<0.05）；并且治療組血清FPG和HbA1c水平降低較明顯（P<0.05）。治療后，兩組血清腫瘤壞死因子-α（TNF-α）和白細(xì)胞介素-6（IL-6）水平顯著降低（P<0.05）；并且治療組血清TNF-α和IL-6水平降低較明顯（P<0.05）。治療后，兩組血清超氧化物歧化酶（SOD）水平顯著升高，丙二醛（MDA）水平顯著降低（P<0.05）；并且治療組血清氧化應(yīng)激指標(biāo)水平改善較明顯（P<0.05）。結(jié)論 腎衰寧膠囊聯(lián)合坎地沙坦酯片治療糖尿病腎病具有較好的臨床療效，能夠改善患者腎功能和血糖，降低血清炎性因子水平，改善血清氧化應(yīng)激指標(biāo)水平。

Objective To study the effect of Shenshuaining Capsules combined with Candesartan Cilexetil Tablets in treatment of diabetic nephropathy. Methods Patients (65 cases) with diabetic nephropathy in Jinshui District General Hospital of Zhengzhou from December 2018 to December 2019 were randomly divided into the control group (32 cases) and the treatment groups (33 cases). Patients in the control group were po administered with Candesartan Cilexetil Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Shenshuaining Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 30 d. After treatment, the clinical efficacies were evaluated, and renal function index, blood glucose level, serum inflammatory factor level, and oxidative stress index in two groups were compared. Results After treatment, the total effective rates of the control and treatment groups were 81.25% and 93.94%, respectively, and the clinical efficacy of the treatment group was significantly higher than that of the control group (P < 0.05). After treatment, the 24 h urinary protein quantitation, BUN, UAER, and Scr of two groups were significantly decreased (P < 0.05). And the renal function index of the treatment group was significantly improved than that of the control group (P < 0.05). After treatment, the levels of FPG and HbA1c in two groups were significantly decreased (P < 0.05). And the levels of FPG and HbA1c in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of TNF-α and IL-6 in two groups were significantly decreased (P < 0.05). And the serum levels of TNF-α and IL-6 in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of SOD and MDA in two groups were significantly increased (P < 0.05). And the serum level of oxidative stress in the treatment group was significantly improved than that in the control group (P < 0.05). Conclusion Shenshuaining Capsules combined with Candesartan Cilexetil Tablets has clinical effect in treatment of diabetic nephropathy, can improve the renal function and blood glucose, reduce the serum level of inflammatory factors, and improve the serum level of oxidative stress indicators.

R983

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃省部共建項(xiàng)目（SB201901075）