目的 探讨百令胶囊联合胰激肽原酶治疗2型糖尿病肾病的临床疗效。方法 纳入2023年10月—2025年8月广安门医院保定医院收治的108例2型糖尿病肾病患者，按照随机数字表法平分为对照组和治疗组。对照组餐前整片吞服胰激肽原酶肠溶片，240 U/次，3次/d。在此基础上，治疗组饭后口服百令胶囊，2片/次，3次/d。疗程12周。比较两组临床疗效，及治疗前后肾功能指标、中医症状积分、超简抑郁焦虑筛查量表（PHQ-4）评分、简化版肾脏病生活质量量表（KDQOL-36）评分、血小板与淋巴细胞比值（PLR）和血清补体C3、C4、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）水平。结果 治疗组的总有效率[94.44%（51/54）]较对照组[81.48%（44/54）]更高（P＜0.05）。治疗后，两组血肌酐（Scr）、尿素氮（BUN）、24 h尿蛋白定量（24 h UP）、尿白蛋白与肌酐比值（UACR）下降，而肾小球滤过率（eGFR）上升（P＜0.05），且治疗组Scr、BUN、24 h UP、UACR和eGFR优于对照组（P＜0.05）。治疗后，两组中医症状积分、PHQ-4评分及PLR和TNF-α、IL-6水平降低（P＜0.05），KDQOL-36评分及血清补体C3、C4水平升高（P＜0.05），且治疗组中医症状积分和PHQ-4、KDQOL-36评分及PLR和血清补体C3、C4及TNF-α、IL-6水平优于对照组（P＜0.05）。结论 百令胶囊联合胰激肽原酶治疗2型糖尿病肾病，能有效发挥免疫调节、抑制炎症反应及改善微循环的作用，进一步减轻肾损伤，促进患者症状缓解及情绪状态和生活质量改善，且具有良好的安全性。

Objective To investigate the clinical efficacy of Bailing Capsules combined with pancreatic kininogenase in treatment of type 2 diabetic nephropathy. Methods A total of 108 patients with type 2 diabetic nephropathy admitted to Guang’anmen Hospital Baoding Hospital from October 2023 to August 2025 were enrolled and equally divided into a control group and a treatment group using a random number table method. The control group received Pancreatic Kininogenase Enteric-coated Tablets, 240 U per dose, three times daily, swallowed whole before meals. On this basis, the treatment group received Bailing Capsules orally, 2 capsules per dose, three times daily, after meals. The treatment duration was 12 weeks. The clinical efficacy, renal function indicators, traditional Chinese medicine symptom scores, Patient Health Questionnaire-4 (PHQ-4) scores, Kidney Disease Quality of Life-36 (KDQOL-36) scores, platelet-to-lymphocyte ratio (PLR), and serum levels of complement C3, complement C4, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were compared between the two groups before and after treatment. Results The total effective rate in the treatment group [94.44% (51/54)] was higher than that in the control group [81.48% (44/54)] (P < 0.05). After treatment, serum creatinine (Scr), blood urea nitrogen (BUN), 24-hour urinary protein (24 h UP), and urine albumin-to-creatinine ratio (UACR) decreased, while estimated glomerular filtration rate (eGFR) increased in both groups (P < 0.05). Moreover, the treatment group showed superior improvements in Scr, BUN, 24 h UP, UACR, and eGFR compared to the control group (P < 0.05). After treatment, traditional Chinese medicine symptom scores, PHQ-4 scores, PLR, and levels of TNF-α and IL-6 decreased in both groups (P < 0.05), while KDQOL-36 scores and serum levels of complement C3 and C4 increased (P < 0.05). Furthermore, the treatment group showed better outcomes than the control group in terms of traditional Chinese medicine symptom scores, PHQ-4 and KDQOL-36 scores, PLR, and serum levels of complement C3, complement C4, TNF-α, and IL-6 (P < 0.05). Conclusion The combination of Bailing Capsules and pancreatic kininogenase in treatment of type 2 diabetic nephropathy effectively exerts immunomodulatory, anti-inflammatory, and microcirculation-improving effects, further alleviates renal injury, promotes symptom relief, and improves emotional status and quality of life, with a favorable safety profile.

R977

保定市社发类项目(2341ZF293)