目的 探讨黄葵胶囊联合吡格列酮治疗早期糖尿病肾病的临床疗效。方法 纳入2023年1月—2025年1月中国人民解放军空军第九八六医院收治的115例早期糖尿病肾病患者的病例资料进行回顾性分析，按治疗方法不同分为对照组（57例）和治疗组（58例）。对照组早餐后30 min口服盐酸吡格列酮片，30 mg/次，1次/d。在对照组基础上，治疗组饭后口服黄葵胶囊，5粒/次，3次/d。两组患者治疗12周。观察两组患者临床疗效，比较治疗前后两组患者临床表现评分，肾功能指标肌酐（Cr）、尿素氮（BUN）、白蛋白（ALB）、估算的肾小球滤过率（eGFR）、24 h尿蛋白定量（24h UP）、尿白蛋白/肌酐比值（UACR）和尿微量白蛋白（mAlb），及糖尿病痛苦量表（DDS）、慢性病患者生命质量量表系列–糖尿病量表（QLICD-DM）和糖尿病并发症恐惧问卷（FCQ）评分。结果 治疗后，治疗组总有效率为94.83%，明显高于对照组（82.46%，P＜0.05）。治疗后，两组水肿、气短乏力、呕恶纳呆等临床表现评分均明显低于治疗前（P＜0.05），且治疗组评分较对照组降低更明显（P＜0.05）。治疗后，两组血清Cr、BUN和24 h UP、UACR、mAlb均比治疗前显著下降，而血清ALB和eGFR则显著上升（P＜0.05），且治疗组这些肾功能相关指标变化较对照组更明显（P＜0.05）。治疗后，两组DDS和FCQ评分均明显下降，而QLICD-DM评分显著升高（P＜0.05），且治疗组评分改善较对照组更明显（P＜0.05）。结论 黄葵胶囊联合吡格列酮治疗早期糖尿病肾病，不良反应较小，且能进一步抑制患者的肾功能损伤，缓解临床症状，促进患者痛苦程度、恐惧心理减轻及生活质量改善。

Objective To investigate the clinical efficacy of Huangkui Capsules combined with pioglitazone in treatment of early diabetic nephropathy. Methods The clinical data of patients (115 cases) with early diabetic nephropathy in the 986th Hospital of PLAAF from January 2023 to January 2025 were analyzed retrospectively. They were divided into control (57 cases) and treatment (58 cases) group based on different treatments. Patients in the control group were po administered with Pioglitazone Hydrochloride Tablets 30 min after breakfast, 30 mg/time, once daily. Patients in the treatment group were po administered with Huangkui Capsules on the basis of the control group, 5 grains/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical evaluations were evaluated, and the clinical performance scores, renal function related indicators Cr, BUN, 24 h UP, UACR, mAlb, ALB and eGFR, and the DDS, QLICD-DM and FCQ scores in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was 94.83%, which was significantly higher than that in the control group (82.46%, P < 0.05). After treatment, the scores of clinical manifestations such as edema, shortness of breath, fatigue, nausea and nausea in two groups were significantly lower than those before treatment (P < 0.05), and the scores in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, serum Cr, BUN, 24 h UP, UACR, and mAlb were significantly decreased in two groups compared with before treatment, while serum ALB and eGFR were significantly increased (P < 0.05), and the changes of renal function-related indicators in the treatment group were more significant than those in the control group (P < 0.05). After treatment, the DDS and FCQ scores were significantly decreased in two groups, while the QLICD-DM score was significantly increased (P < 0.05), and the score improvement in the treatment group was more significant than that in the control group (P < 0.05). Conclusion Huangkui Capsules combined with pioglitazone in treatment of early diabetic nephropathy has less side effects, and can further inhibit the patient’s renal function injury, relieve clinical symptoms, promote the patient′s pain, reduce fear and improve the quality of life.

R977