目的 探讨尿毒清颗粒联合格列喹酮治疗2型糖尿病肾病的临床疗效。方法 纳入2022年9月—2024年12月首都医科大学附属北京友谊医院收治的98例2型糖尿病肾病患者，按照随机数字表法分为对照组和治疗组，每组各49例。对照组餐前30 min口服格列喹酮片，15 mg/次，3次/d。在对照组基础上，治疗组口服尿毒清颗粒，每天6:00时、12:00时、18:00时各服用1次，1袋/次，22:00服用2袋，4次/d。两组疗程12周。观察两组临床疗效，比较治疗前后两组中医症状总积分、肾脏病专用生活质量简表（KDQOL-36）评分、尿液检测指标24 h尿蛋白定量（24 h-UTP）、尿白蛋白排泄率（AER）、尿白蛋白/肌酐比值（ACR）、肾功能指标血清肌酐（Cr）、血尿素氮（BUN）、胱抑素C（Cys-C）、全身炎症反应指数（SIRI）、HALP评分及血清生长分化因子-15（GDF-15）、转化生长因子-β1（TGF-β1）、高迁移率族蛋白1（HMGB1）水平。结果 治疗后，治疗组总有效率明显高于对照组（93.88% vs 79.59%，P＜0.05）。治疗后，两组中医症状总积分均明显低于同组治疗前，而KDQOL-36评分高于治疗前（P＜0.05），且治疗组评分均明显优于对照组（P＜0.05）。治疗后，两组各项尿液检测指标24 h-UTP、AER、ACR都低于同组治疗前（P＜0.05），且治疗组尿液检测指标均低于对照组（P＜0.05）。治疗后，两组各项肾功能指标均低于同组治疗前（P＜0.05），且治疗组肾功能指标明显低于对照组（P＜0.05）。治疗后，两组SIRI评分和血清GDF-15、TGF-β1、HMGB1水平都降低治疗前，而HALP评分均增加（P＜0.05），且治疗组患者这些指标均显著优于对照组（P＜0.05）。结论 采用尿毒清颗粒联合格列喹酮治疗2型糖尿病肾病，效果确切，可通过协同抗炎抗纤维化、改善营养免疫状态，保护肾功能，减轻患者症状，提升生活质量，且安全性良好。

Objective This study aimed to evaluate the clinical efficacy of Niaoduqing Granules combined with gliquidone in the treatment of type 2 diabetic nephropathy (T2DN). Methods A total of 98 patients with T2DN admitted to Beijing Friendship Hospital, Capital Medical University, from September 2022 to December 2024 were enrolled and divided into control group and treatment group by random number table method, with 49 cases in each group. The control group received oral gliquidone tablets at 15 mg three times daily, 30 minutes before meals. On the basis of the control treatment, the treatment group was additionally administered Niaoduqing Granules four times per day: one sachet at 6:00, 12:00, and 18:00, and two sachets at 22:00. The treatment course lasted 12 weeks for both groups. The clinical efficacy was assessed. Traditional Chinese medicine (TCM) symptom scores and the 36-item Kidney Disease Quality of Life Questionnaire (KDQOL-36) scores were compared before and after treatment. Urinary indicators including 24-hour urinary total protein (24 h-UTP), urinary albumin excretion rate (AER), and urinary albumin/creatinine ratio (ACR) were detected. Renal function parameters (serum creatinine [Cr], blood urea nitrogen [BUN], cystatin C [Cys-C]), systemic inflammatory response index (SIRI), HALP score, as well as serum levels of growth differentiation factor-15 (GDF-15), transforming growth factor-β1 (TGF-β1), and high mobility group box 1 (HMGB1) were also measured. Results After treatment, the total effective rate in the treatment group was significantly higher than that in the control group (93.88% vs 79.59%, P < 0.05). After treatment, the total traditional Chinese medicine (TCM) symptom scores were significantly decreased, while the KDQOL-36 scores were increased in both groups (P < 0.05). And TCM symptom scores and KDQOL-36 scores were in the treatment group were better than those in the control group (P < 0.05). After treatment, urinary test indicators including 24-h-UTP, AER and ACR were reduced in both groups (P < 0.05), with they were lower in the treatment group than those in the control group (P< 0.05). Renal function parameters were also decreased after treatment in both groups (P < 0.05), and these parameters were significantly lower in the treatment group than those in the control group (P< 0.05). After treatment, the SIRI score and serum levels of GDF-15, TGF-β1, and HMGB1 were decreased, while the HALP score was elevated in both groups (P < 0.05). These indicators in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion The combination of Niaoduqing Granules and gliquidone exerts a reliable therapeutic effect on T2DN. This synergistic regimen protects renal function by inhibiting inflammation and renal fibrosis, optimizing nutritional and immune status, alleviating clinical symptoms, and improving patients’ quality of life, with a favorable safety profile.

R977