目的 探討至靈膠囊聯(lián)合替米沙坦治療早期糖尿病腎病的臨床療效。方法 選取2013年1月-2016年1月天津市第一中心醫(yī)院收治的98例糖尿病腎病患者，隨機(jī)分為對照組（50例）和治療組（48例）。對照組患者口服替米沙坦片，1片/次，1次/d。治療組在對照組治療基礎(chǔ)上口服至靈膠囊，2粒/次，3次/d。兩組均連續(xù)治療12周。觀察兩組的臨床療效，比較兩組患者治療前后24 h尿蛋白定量、血肌酐（Scr）、尿酸（UA）、腫瘤壞死因子-α（TNF-α）、C-反應(yīng)蛋白（CRP）、白介素-6（IL-6）、內(nèi)皮素（ET）、一氧化氮（NO）的變化情況。結(jié)果 治療后，對照組和治療組的總有效率分別為80.00%、93.75%，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組24 h尿蛋白定量、Scr、UA、TNF-α、IL-6、CRP、ET均較治療前明顯降低，NO較治療前明顯升高，同組治療前后比較差異具有統(tǒng)計學(xué)意義（P<0.05）；治療后，治療組24 h尿蛋白定量、Scr、UA、TNF-α、IL-6、CRP、ET水平顯著低于對照組，NO較治療前明顯升高，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 至靈膠囊聯(lián)合替米沙坦治療糖尿病腎病具有較好的臨床療效，可有效降低炎癥因子水平，改善血管內(nèi)皮功能，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the efficacy of Zhiling Capsule combined with telmisartan in treatment of early diabetic nephropathy. Methods Patients (98 cases) with early diabetic nephropathy in Tianjin First Center Hospital from January 2013 to January 2016 were randomly divided into control (50 cases) and treatment (48 cases) groups. Patients in the control group were po administered with Telmisartan Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Zhiling Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the changes of 24 h urinary protein quantification, Scr, UA, TNF-α, CRP, IL-6, ET, and NO in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group were 80.00% and 93.75%, and there were differences between two groups (P<0.05). After treatment, 24 h urinary protein quantification, Scr, UA, TNF-α, IL-6, CRP, and ET in two groups were significantly decreased, but NO was significantly increased, and there were differences in the same group (P<0.05). After treatment, 24 h urinary protein quantification, Scr, UA, TNF-α, IL-6, CRP, and ET in the treatment group were lower than those in the control group, but NO was higher than that in the control group, and there were differences between two groups (P<0.05). Conclusion Zhiling Capsule combined with telmisartan has significant clinical effect in treatment of early diabetic nephropathy, and can effectively reduce the level of inflammatory factors and improve vascular endothelial function, which has a certain clinical application value.