目的 探討黃芪注射液聯合螺內酯片治療糖尿病腎病的臨床療效。方法 選取2015年9月-2017年8月江漢油田總醫(yī)院收治的糖尿病腎病患者96例作為研究對象，根據隨機分組法將所有患者分為對照組和治療組，每組各48例。對照組口服螺內酯片，20 mg/次，2次/d。治療組在對照組基礎上靜脈滴注黃芪注射液，40 mL加入到0.9%氯化鈉250 mL中，1次/d。兩組均連續(xù)治療1個月。觀察兩組的臨床療效，比較兩組的腎功能指標、炎性因子水平、穩(wěn)態(tài)模型評估-胰島素抵抗指數（HOMA-IR）。結果 治療后，對照組和治療組的總有效率分別為70.8%、91.7%，兩組比較差異有統計學意義（P<0.05）。治療后，兩組24 h微量白蛋白（mALB）、尿素氮（BUN）、血肌酐（Scr）、尿白蛋白排泄率（UAER）、β₂-微球蛋白（β₂-MG）水平均顯著降低，同組治療前后比較差異具有統計學意義（P<0.05）；且治療組這些腎功能指標明顯低于對照組，兩組比較差異具有統計學意義（P<0.05）。治療后，兩組C反應蛋白（CRP）、腫瘤壞死因子-α（TNF-α）、白細胞介素-6（IL-6）、HOMA-IR水平均顯著降低，同組治療前后比較差異具有統計學意義（P<0.05）；且治療組這些觀察指標明顯優(yōu)于對照組，兩組比較差異具有統計學意義（P<0.05）。結論 黃芪注射液聯合螺內酯片治療糖尿病腎病具有較好的臨床療效，可改善腎功能，調節(jié)炎性因子，具有一定的臨床推廣應用價值。

Objective To investigate the efficacy of Huangqi Injection combined with Spironolactone Tablets in treatment of diabetic nephropathy. Methods Patients (96 cases) with diabetic nephropathy in Jianghan Oil Field General Hospital from September 2015 to August 2017 were randomly divided into control and treatment groups, and each group had 48 cases. Patients in the control group were po administered with Spironolactone Tablets, 20 mg/time, twice daily. Patients in the treatment group were iv administered with Huangqi Injection on the basis of the control group, 40 mL added into normal saline 250 mL, once daily. Patients in two groups were treated for 1 month. After treatment, the clinical efficacies were evaluated, and kidney function indexes, inflammatory factors, and HOMA-IR in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 70.8% and 91.7%, respectively, and there was difference between two groups (P < 0.05). After treatment, the levels of 24 h mALB, BUN, Scr, UAER, and β₂-MG in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the kidney function indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the levels of CRP, TNF-α, IL-6, and HOMA-IR in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the inflammatory factors and HOMA-IR in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Huangqi Injection combined with Spironolactone Tablets has clinical curative effect in treatment of diabetic nephropathy, can improve kidney function, and regulate inflammatory factors, which has a certain clinical application value.