目的 探讨肾衰宁胶囊联合阿魏酸钠治疗2型糖尿病肾病的临床疗效。方法 纳入2023年5月—2025年4月河北北方学院附属第一医院收治的2型糖尿病肾病患者80例，随机分为对照组和治疗组，每组各40例。对照组静脉滴注注射用阿魏酸钠，0.3 g加入250 mL生理盐水，静脉滴注时间≥50 min，1次/d。在对照组基础上，治疗组口服肾衰宁胶囊，5粒/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肾功能指标24 h尿蛋白定量（24 h UP）、尿微量白蛋白/肌酐比值（UACR）、血肌酐（Scr）、尿素氮（BUN）和肾小球滤过率（GFR）水平，简式抑郁–焦虑–压力量表（DASS-21）、世界卫生组织生活质量测定简表（WHOQOL-BREF）和中医症状积分，血液流变学指标红细胞聚集指数（EAI）、红细胞变形指数（EDI）和血浆黏度（PV）和血小板聚集率（PAgT），血清肾损伤分子-1（Kim-1）、血管生成素样蛋白4（ANGPTL4）和白细胞介素-27（IL-27）水平。结果 治疗后治疗组总有效率为95.00%，显著高于对照组的80.00%（P＜0.05）。治疗后，两组肾功能指标24 h UP、UACR、Scr、BUN水平均降低，而GFR水平显著增高（P＜0.05），且治疗组肾功能指标均显著优于对照组（P＜0.05）。治疗后，两组DASS-21评分和中医症状积分降低，而WHOQOL-BREF评分显著增加（P＜0.05），且治疗组患者上述评分均显著优于对照组（P＜0.05）。治疗后，两组血清血液流变学指标EAI、PV、PAgT均降低，而EDI升高（P＜0.05），且治疗组血液流变学指标均显著优于对照组（P＜0.05）。治疗后，两组血清Kim-1、ANGPTL4、IL-27水平均下降（P＜0.05），且治疗组患者明显低于对照组（P＜0.05）。结论 肾衰宁胶囊联合阿魏酸钠治疗2型糖尿病肾病，能有效缓解蛋白尿和临床症状，纠正血液流变学异常，抑制炎症损伤及纤维化进程，对保护肾功能及改善患者负性情绪和生活质量具有良好作用。

Objective To explore the clinical efficacy of Shenshuaining Capsules combined with sodium ferulate in treatment of type 2 diabetic nephropathy. Methods Patients (80 cases) with type 2 diabetic nephropathy in the First Affiliated Hospital of Hebei North University from May 2023 to April 2025 were randomly divided into control and treatment group, and each group had 40 cases. Patients in the control group were iv administered with Sodium Ferulate for injection, 0.3 g added into normal saline 250 mL, the treatment time was more than 50 min, once daily. Patients in the treatment group were po administered with Shenshuaining Capsules on the basis of the control group, 5 grains/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical evaluations were evaluated, and the renal function indexes 24 h UP, UACR, Scr, BUN and GFR levels, the scores of DASS-21, WHOQOL-BREF and TCM symptom scores, hemorheological indicators EAI, PV, PagT and EDI, and the levels of serum Kim-1, ANGPTL4 and IL-27 in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was 95.00%, which was significantly higher than 80.00% in the control group (P < 0.05). After treatment, the levels of 24-hour UP, UACR, Scr, and BUN in two groups were decreased, while the level of GFR was increased significantly (P < 0.05), and the renal function indicators in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the DASS-21 and TCM symptom scores were decreased in two groups, while the WHOQOL-BREF score was increased significantly (P < 0.05), and the scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, serum hemorheology indicators EAI, PV, and PAgT were decreased in two groups, while EDI was increased (P < 0.05), and the hemorheology indicators in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the serum levels of Kim-1, ANGPTL4, and IL-27 in two groups were decreased (P < 0.05), and which were significantly lower in the treatment group than those in the control group (P < 0.05). Conclusion The treatment of type 2 diabetic nephropathy with Shenshuaining Capsules combined with sodium ferulate can effectively relieve proteinuria and clinical symptoms, correct abnormal hemorheology, inhibit inflammatory damage and fibrosis process, and has a good effect on protecting renal function and improving patients’ negative emotions and quality of life.

R983

张家口市科技计划自筹经费项目（2421067D）