目的 探討金水寶膠囊聯(lián)合依帕司他片治療糖尿病腎病的臨床療效。方法 選取2014年9月—2017年4月商丘市第一人民醫(yī)院收治的糖尿病腎病患者172例，隨機(jī)分為對照組和治療組，每組各86例。對照組口服依帕司他片，50 mg/次，1次/d。治療組在對照組治療的基礎(chǔ)上口服金水寶膠囊，3粒/次，3次/d。兩組患者均連續(xù)治療8周。觀察兩組的臨床療效，比較兩組的血糖、腎功能指標(biāo)、24 h尿微量蛋白定量、血清氧化指標(biāo)和血清抗氧化指標(biāo)。結(jié)果 治療后，對照組和治療組的總有效率分別為75.6%、93.0%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組空腹血糖、糖化血紅蛋白水平均顯著降低，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組血糖指標(biāo)明顯低于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組血清肌酐（Scr）、尿素氮（BUN）、胱抑素C（Cys-C）、血清β₂微球蛋白（β₂-MG）、24 h尿微量蛋白定量、尿蛋白排泄率（UAER）水平均顯著降低，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)明顯低于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組活性氧（ROS）、脂質(zhì)過氧化氫（LHP）和晚期蛋白氧化產(chǎn)物（AOPPS）水平均顯著下降，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組血清氧化指標(biāo)明顯低于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組超氧化物歧化酶（SOD）、維生素E（VitE）、維生素C（VitC）和總抗氧化能力（T-AOC）水平均顯著升高，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組血清抗氧化指標(biāo)明顯高于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 金水寶膠囊聯(lián)合依帕司他片治療糖尿病腎病具有較好的臨床療效，可改善腎功能，增強(qiáng)抗氧化能力，降低氧化反應(yīng)，具有一定臨床推廣應(yīng)用價值。

Objective To investigate the effects of Jinshuibao Capsules combined with Epalrestat Tablets in treatment of diabetic nephropathy. Methods Patients (172 cases) with diabetic nephropathy in Shangqiu First People's Hospital from September 2014 to April 2017 were randomly divided into control and treatment groups, and each group had 86 cases. Patients in the control group were po administered with Epalrestat Tablets, 50 mg/time, once daily. Patients in the treatment group were po administered with Jinshuibao Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacies were evaluated, and blood glucose, renal function indexes, 24 h urine microprotein, serum oxidation indexes, and serum antioxidant indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 75.6% and 93.0%, respectively, and there was difference between two groups (P<0.05). After treatment, the levels of fasting blood sugar and glycosylated hemoglobin in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And blood glucose index leveles 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 Scr, BUN, Cys-C, β₂-MG, 24 h urine microprotein and UAER in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the renal 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 ROS, LHP, and AOPPS in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the serum oxidation 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 SOD, VitE, VitC, and T-AOC in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the serum antioxidant indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). Conclusion Jinshuibao Capsules combined with Epalrestat Tablets has clinical curative effect in treatment of diabetic nephropathy, can improve renal function, enhance antioxidant capacity, and reduce oxidation reaction, which has a certain application value.