目的 探讨金水宝胶囊联合舒洛地特治疗早期糖尿病肾病的临床效果。方法 选取2015年1月—2018年1月河北大学附属医院收治的早期糖尿病肾病患者80例，随机分成对照组（40例）和治疗组（40例）。对照组口服舒洛地特软胶囊，1粒/次，2次/d。治疗组在对照组基础上口服金水宝胶囊，6粒/次，3次/d。两组患者均连续治疗4个月。观察两组患者临床疗效，同时比较治疗前后两组患者尿白蛋白排泄率（UAE）、24 h尿蛋白定量（24 h-UTP）值、血清肌酐（Cr）和尿素氮（BUN）水平、血脂、内皮功能、炎症及氧化应激指标和肾动脉血流参数。结果 治疗后，对照组的总有效率为75.0%，显著低于治疗组的92.5%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组UAE、24 h-UTP值及血清Cr、BUN水平均显著降低（P<0.05），且治疗组患者UAE、24 h-UTP值及血清Cr、BUN水平明显低于对照组（P<0.05）。治疗后，两组血清三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、内皮素（ET）-1、C反应蛋白（CRP）浓度及外周血中性粒细胞与淋巴细胞比值（NLR）较治疗前均显著降低（P<0.05），血清降钙素基因相关肽（CGRP）、超氧化物歧化酶（SOD）水平则均显著升高（P<0.05），且治疗组患者上述血脂、内皮功能、炎症及氧化应激指标水平明显好于对照组（P<0.05）。治疗后，两组患者肾动脉血流参数RI和PI值均显著降低（P<0.05），且治疗组患者RI和PI值明显低于对照组（P<0.05）。结论 金水宝胶囊联合舒洛地特治疗早期糖尿病肾病能有效减少患者尿蛋白排泄，保护肾功能，纠正脂质代谢紊乱，改善微循环及肾脏血流动力学。

Objective To investigate the clinical effect of Jinshuibao Capsules combined with sulodexide in treatment of early diabetic nephropathy. Methods Patients (80 cases) with early diabetic nephropathy in Affiliated Hospital of Hebei University from January 2015 to January 2018 were randomly divided into control (40 cases) and treatment (40 cases) groups. Patients in the control group were po administered with Sulodexide Soft Capsules, 1 grain/time, twice daily. Patients in the treatment group were po administered with Jinshuibao Capsules on the basis of the control group, 6 grains/time, three times daily. Patients in two groups were treated for 4 months. After treatment, the clinical efficacy was evaluated, and the UAE, 24 h-UTP, serum Cr and BUN levels, blood lipid, endothelial function, inflammation, oxidative stress indexes, renal artery blood flow parameters in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 75.0%, which was significantly lower than 92.5% in the treatment group, and there were differences between two groups (P < 0.05). After treatment, the UAE, 24 h-UTP, serum Cr, and BUN levels in two groups were significantly decreased (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the TG, LDL-C, ET-1 and CRP concentration, and NLR of peripheral blood in two groups were significantly decreased (P < 0.05), but CGRP and SOD levels were significantly increased (P < 0.05), and these indicators levels in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the renal artery blood flow parameters RI and PI value in two groups was significantly decreased (P < 0.05), and which in the treatment group were significantly lower than that in the control group (P < 0.05). Conclusion Jinshuibao Capsules combined with sulodexide in treatment of early diabetic nephropathy can effectively reduce urinary protein excretion, protect renal function, correct lipid metabolism disorder, improve microcirculation and renal hemodynamics.