目的 探讨桂附地黄丸联合厄贝沙坦治疗糖尿病肾病的临床疗效。方法 选取2021年1月—2023年4月在中国人民解放军陆军第七十三集团军医院治疗的糖尿病肾病患者104例，采用随机数表法患者分为对照组（52例）和治疗组（52例）。对照组患者口服厄贝沙坦片，150 mg/d。治疗组在对照组基础上口服桂附地黄丸，8丸/次，3次/d。两组患者治疗3个月。观察两组患者临床疗效，比较治疗前后两组患者肌酐、尿白蛋白与肌酐的比值（UACR）、尿素氮、中性粒细胞与淋巴细胞计数比值（NLR）、超敏C反应蛋白（hs-CRP）和白细胞介素-1β（IL-1β）水平及中医症状积分。结果 治疗后，治疗组总有效率为94.23%，明显高于对照组的80.77%（P＜0.05）。治疗后，两组肌酐、UACR、尿素氮、hs-CRP、NLR、IL-1β水平均明显低于治疗前（P＜0.05），且治疗组肾功能和炎症指标均明显低于对照组（P＜0.05）。治疗后，两组肢体浮肿、畏寒肢冷、腰膝酸软积分均低于治疗前（P＜0.05），且治疗组的中医症状积分均低于对照组（P＜0.05）。结论 桂附地黄丸联合厄贝沙坦治疗糖尿病肾病具有较好的临床疗效，可显著改善患者的肾功能，降低体内的炎症反应，且安全性较高。

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

福建省卫生健康青年科研课题资助计划（2021QNA051）