目的 探討桂附地黃丸聯(lián)合厄貝沙坦治療糖尿病腎病的臨床療效。方法 選取2021年1月—2023年4月在中國人民解放軍陸軍第七十三集團(tuán)軍醫(yī)院治療的糖尿病腎病患者104例，采用隨機(jī)數(shù)表法患者分為對(duì)照組（52例）和治療組（52例）。對(duì)照組患者口服厄貝沙坦片，150 mg/d。治療組在對(duì)照組基礎(chǔ)上口服桂附地黃丸，8丸/次，3次/d。兩組患者治療3個(gè)月。觀察兩組患者臨床療效，比較治療前后兩組患者肌酐、尿白蛋白與肌酐的比值（UACR）、尿素氮、中性粒細(xì)胞與淋巴細(xì)胞計(jì)數(shù)比值（NLR）、超敏C反應(yīng)蛋白（hs-CRP）和白細(xì)胞介素-1β（IL-1β）水平及中醫(yī)癥狀積分。結(jié)果 治療后，治療組總有效率為94.23%，明顯高于對(duì)照組的80.77%（P＜0.05）。治療后，兩組肌酐、UACR、尿素氮、hs-CRP、NLR、IL-1β水平均明顯低于治療前（P＜0.05），且治療組腎功能和炎癥指標(biāo)均明顯低于對(duì)照組（P＜0.05）。治療后，兩組肢體浮腫、畏寒肢冷、腰膝酸軟積分均低于治療前（P＜0.05），且治療組的中醫(yī)癥狀積分均低于對(duì)照組（P＜0.05）。結(jié)論 桂附地黃丸聯(lián)合厄貝沙坦治療糖尿病腎病具有較好的臨床療效，可顯著改善患者的腎功能，降低體內(nèi)的炎癥反應(yīng)，且安全性較高。

Objective To explore the clinical efficacy of Guifu Dihuang Pills combined with irbesartan in the treatment of diabetes nephropathy. Methods Patients (104 cases) with diabetes nephropathy in the 73rd Group Army Hospital of the PLA from January 2021 to April 2023 were divided into control (52 cases) and treatment (52 cases) group by random number table method. Patients in the control group were po administered with Irbesartan Tablets, 150 mg/d. Patients in the treatment group were po administered with Guifu Dihuang Pills on the basis of the control group, 8 pills/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical evaluations were evaluated, the levels of creatinine, UACR, urea nitrogen, hs-CRP, NLR and IL-1β, and TCM symptom scores in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 94.23%, which was significantly higher than that of the control group (80.77%, P < 0.05). After treatment, the levels of creatinine, UACR, urea nitrogen, hs-CRP, NLR and IL-1β in two groups were significantly lower than those before treatment (P < 0.05), and the renal function and inflammatory indexes in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the scores of limb edema, cold limbs and waist and knee tenderness in both groups were lower than before treatment (P < 0.05), and the scores of TCM symptoms in the treatment group were lower than those in the control group (P < 0.05). Conclusion Guifu Dihuang Pills combined with Irbesartan has good clinical efficacy in the treatment of diabetes nephropathy, can significantly improve the renal function and inflammatory reaction of patients, and has high safety.

R977

福建省衛(wèi)生健康青年科研課題資助計(jì)劃（2021QNA051）