目的 研究肾衰宁胶囊联合坎地沙坦酯片治疗糖尿病肾病的临床疗效。方法 选取2018年12月-2019年12月郑州市金水区总医院收治的65例糖尿病肾病患者，将所有患者随机分为对照组（32例）和治疗组（33例）。对照组患者口服坎地沙坦酯片，1片/次，1次/d。治疗组在对照组基础上口服肾衰宁胶囊，4粒/次，3次/d。两组患者持续治疗30 d。观察两组患者临床疗效，比较两组的肾功能指标、血糖水平、血清炎性因子水平、氧化应激指标。结果 治疗后，对照组和治疗组患者的总有效率分别为81.25%、93.94%，治疗组的临床疗效显著高于对照组（P<0.05）。治疗后，两组24 h尿蛋白定量、尿素氮（BUN）、尿白蛋白排泄率（UAER）、血肌酐（Scr）水平均显著降低（P<0.05）；并且治疗组肾功能指标改善较明显（P<0.05）。治疗后，两组血清空腹血糖（FPG）和糖化血红蛋白（HbA1c）水平显著降低（P<0.05）；并且治疗组血清FPG和HbA1c水平降低较明显（P<0.05）。治疗后，两组血清肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）水平显著降低（P<0.05）；并且治疗组血清TNF-α和IL-6水平降低较明显（P<0.05）。治疗后，两组血清超氧化物歧化酶（SOD）水平显著升高，丙二醛（MDA）水平显著降低（P<0.05）；并且治疗组血清氧化应激指标水平改善较明显（P<0.05）。结论 肾衰宁胶囊联合坎地沙坦酯片治疗糖尿病肾病具有较好的临床疗效，能够改善患者肾功能和血糖，降低血清炎性因子水平，改善血清氧化应激指标水平。

Objective To study the effect of Shenshuaining Capsules combined with Candesartan Cilexetil Tablets in treatment of diabetic nephropathy. Methods Patients (65 cases) with diabetic nephropathy in Jinshui District General Hospital of Zhengzhou from December 2018 to December 2019 were randomly divided into the control group (32 cases) and the treatment groups (33 cases). Patients in the control group were po administered with Candesartan Cilexetil Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Shenshuaining Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 30 d. After treatment, the clinical efficacies were evaluated, and renal function index, blood glucose level, serum inflammatory factor level, and oxidative stress index in two groups were compared. Results After treatment, the total effective rates of the control and treatment groups were 81.25% and 93.94%, respectively, and the clinical efficacy of the treatment group was significantly higher than that of the control group (P < 0.05). After treatment, the 24 h urinary protein quantitation, BUN, UAER, and Scr of two groups were significantly decreased (P < 0.05). And the renal function index of the treatment group was significantly improved than that of the control group (P < 0.05). After treatment, the levels of FPG and HbA1c in two groups were significantly decreased (P < 0.05). And the levels of FPG and HbA1c in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of TNF-α and IL-6 in two groups were significantly decreased (P < 0.05). And the serum levels of TNF-α and IL-6 in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of SOD and MDA in two groups were significantly increased (P < 0.05). And the serum level of oxidative stress in the treatment group was significantly improved than that in the control group (P < 0.05). Conclusion Shenshuaining Capsules combined with Candesartan Cilexetil Tablets has clinical effect in treatment of diabetic nephropathy, can improve the renal function and blood glucose, reduce the serum level of inflammatory factors, and improve the serum level of oxidative stress indicators.

R983

河南省医学科技攻关计划省部共建项目（SB201901075）