目的 探讨渴络欣胶囊联合卡托普利对糖尿病肾病患者氧化应激及肾小管功能的影响。方法 选择常州市武进中医医院2023年8月—2024年12月收治的120例早期糖尿病肾病患者，随机分为对照组和治疗组，每组均为60例。对照组口服卡托普利片，12.5 mg/次，2次/d。治疗组在对照组基础上口服渴络欣胶囊，2 g/次，3次/d。两组均持续治疗60 d。观察两组患者临床疗效，比较治疗前后两组患者中医证候积分，及糖化血红蛋白（HbA1c）、血肌酐（Scr）、尿微量白蛋白排泄率（UAER）、NADPH氧化酶（NOX4）、超氧化物歧化酶（SOD）、总抗氧化能力（T-AOC）、α1-微球蛋白（α1-MG）、肝型脂肪酸结合（L-FABP）和中性粒细胞明胶酶相关脂质运载蛋白（NGAL）水平。结果 治疗后，治疗组总有效率显著优于对照组（P＜0.05）。治疗后，治疗组患者中医证候积分、HbA1c、Scr、UAER、α1-MG、L-FABP、NGAL及NOX4均较对照组显著降低（P＜0.05），治疗组SOD及T-AOC较对照组显著提高（P＜0.05）。结论 渴络欣胶囊联合卡托普利治疗糖尿病肾病有效性及安全性均较高，可有效改善患者中医证候，减轻氧化应激反应，保护肾小管功能。

Objective To explore the effects of Keluoxin Capsules combined with captopril on oxidative stress and renal tubular function in patients with diabetic nephropathy. Methods The clinical data of patients (120 cases) with diabetic nephropathy in Changzhou Wujin Hospital of Traditional Chinese Medicine from August 2023 to December 2024 were randomly divided into control and treatment group, and each group had 60 cases. Patients in the control group were po administered with Captopril Tablets, 1.25 mg/time, twice daily. Patients in the treatment group were po administered with Keluoxin Capsules on the basis of the control group, 2 g/time, three times daily. Patients in two groups were treated for 60 d. After treatment, the clinical evaluations were evaluated, and the TCM syndrome score, the levels of HbA1c, Scr, UAER, NOX4, SOD, T-AOC, α1-MG, L-FABP and NGAL in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was significantly better than that of the control group (P < 0.05). After treatment, the TCM syndrome score, HbA1c, Scr, UAER, α1-MG, L-FABP, NGAL and NOX4 in the treatment group were significantly lower than those in the control group (P < 0.05), the levels of SOD and T-AOC in the treatment group were significantly higher than those in the control group (P < 0.05). Conclusion Keluoxin Capsules combined with captopril is effective and safe in treatment of early diabetic nephropathy, which can effectively improve patients’ TCM syndromes, reduce oxidative stress and protect renal tubular function.

R983

常州市武进区科技计划项目（WS202108）