目的 探究罌粟堿聯(lián)合阿魏酸哌嗪片對糖尿病腎?。―N）患者的臨床療效。方法 選取2021年1月—2024年3月安徽中醫(yī)藥大學附屬太和中醫(yī)院收治的60例DN患者，根據(jù)隨機數(shù)表法將其分為對照組（30例）和觀察組（30例）。所有患者均給予胰島素或降糖藥物治療，對照組在此基礎上給予阿魏酸哌嗪片治療2個月，觀察組在對照組基礎上于住院期間給予罌粟堿注射液聯(lián)合口服藥物8～14 d，出院期間繼續(xù)口服阿魏酸哌嗪片2個月。比較兩組臨床療效和不良反應發(fā)生情況，于治療前和治療2個月后比較兩組腎功能指標[尿素氮（BUN）、24 h尿蛋白定量、尿微量白蛋白]、糖代謝指標[空腹血糖值（FBG）、餐后2 h血糖值（2hPG）、糖化血紅蛋白（HbA1c）]水平及血清炎癥因子[白細胞介素-6（IL-6）、白細胞介素-10（IL-10）、腫瘤壞死因子-α（TNF-α）]水平。結(jié)果 治療2個月后，觀察組臨床總有效率為93.33%，高于對照組的70.00%（P＜0.05）。治療2個月后，兩組BUN、24 h尿蛋白定量、尿微量白蛋白、FBG、2hPG和HbA1c水平均下降，且觀察組低于對照組； 2組IL-6、IL-8和TNF-α水平均下降，且觀察組低于對照組（P＜0.05）。治療期間，觀察組不良反應發(fā)生率為13.33%，與對照組的10.00%比較無差異（P＞0.05）。結(jié)論 罌粟堿聯(lián)合阿魏酸哌嗪片對DN患者有著較好的臨床療效，能有效控制血糖水平，減輕機體炎癥反應，提高腎功能，且不增加不良反應發(fā)生率。

Objective To explore the clinical curative effect of papaverine combined with Piperazine Ferulate Tablet in patients with diabetic nephropathy (DN). Methods A total of 60 patients with DN admitted to the hospital were enrolled between January 2021 and March 2024. According to random number table method, they were divided into control group (30 cases) and observation group (30 cases). On basis of insulin or hypoglycemic drug treatment, control group was treated with Piperazine Ferulate Tablet for two months, while observation group was combined papaverine injection with oral drug was given for 10—14 d during hospitalization on the basis of oral drug group, and oral drug was continued for two months during discharge. The clinical curative effect and adverse reactions, renal function indexes [blood urea nitrogen (BUN), 24 h urinary protein quantification, urinary microalbumin], glucose metabolism indexes [fasting blood glucose (FBG), 2 h postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c)] and serum inflammatory factors [interleukin-6 (IL-6), interleukin-10 (IL^-10), tumor necrosis factor-α (TNF-α)] before and after two months of treatment were compared between the two groups. Results After two months of treatment, total clinical response rate of observation group was higher than that of control group (93.33% vs 70.00%, P < 0.05). After two months of treatment, levels of BUN, 24 h urinary protein quantification, urinary microalbumin, FBG, 2hPG, HbA1c, IL-6, IL-8 and TNF-α were decreased in both groups, which were lower in observation group than control group (P < 0.05). During treatment, there was no significant difference in the incidence of adverse reactions between observation group and control group (13.33% vs 10.00%, P > 0.05). Conclusion Clinical curative effect of papaverine combined with Piperazine Ferulate Tablet is good in patients with DN, which can effectively control blood glucose, relieve inflammatory response and improve renal function, with low incidence of adverse reactions.

R969.4