目的 探究罂粟碱联合阿魏酸哌嗪片对糖尿病肾病（DN）患者的临床疗效。方法 选取2021年1月—2024年3月安徽中医药大学附属太和中医院收治的60例DN患者，根据随机数表法将其分为对照组（30例）和观察组（30例）。所有患者均给予胰岛素或降糖药物治疗，对照组在此基础上给予阿魏酸哌嗪片治疗2个月，观察组在对照组基础上于住院期间给予罂粟碱注射液联合口服药物8～14 d，出院期间继续口服阿魏酸哌嗪片2个月。比较两组临床疗效和不良反应发生情况，于治疗前和治疗2个月后比较两组肾功能指标[尿素氮（BUN）、24 h尿蛋白定量、尿微量白蛋白]、糖代谢指标[空腹血糖值（FBG）、餐后2 h血糖值（2hPG）、糖化血红蛋白（HbA1c）]水平及血清炎症因子[白细胞介素-6（IL-6）、白细胞介素-10（IL-10）、肿瘤坏死因子-α（TNF-α）]水平。结果 治疗2个月后，观察组临床总有效率为93.33%，高于对照组的70.00%（P＜0.05）。治疗2个月后，两组BUN、24 h尿蛋白定量、尿微量白蛋白、FBG、2hPG和HbA1c水平均下降，且观察组低于对照组； 2组IL-6、IL-8和TNF-α水平均下降，且观察组低于对照组（P＜0.05）。治疗期间，观察组不良反应发生率为13.33%，与对照组的10.00%比较无差异（P＞0.05）。结论 罂粟碱联合阿魏酸哌嗪片对DN患者有着较好的临床疗效，能有效控制血糖水平，减轻机体炎症反应，提高肾功能，且不增加不良反应发生率。

Objective To explore the clinical curative effect of papaverine combined with Piperazine Ferulate Tablet in patients with diabetic nephropathy (DN). Methods A total of 60 patients with DN admitted to the hospital were enrolled between January 2021 and March 2024. According to random number table method, they were divided into control group (30 cases) and observation group (30 cases). On basis of insulin or hypoglycemic drug treatment, control group was treated with Piperazine Ferulate Tablet for two months, while observation group was combined papaverine injection with oral drug was given for 10—14 d during hospitalization on the basis of oral drug group, and oral drug was continued for two months during discharge. The clinical curative effect and adverse reactions, renal function indexes [blood urea nitrogen (BUN), 24 h urinary protein quantification, urinary microalbumin], glucose metabolism indexes [fasting blood glucose (FBG), 2 h postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c)] and serum inflammatory factors [interleukin-6 (IL-6), interleukin-10 (IL^-10), tumor necrosis factor-α (TNF-α)] before and after two months of treatment were compared between the two groups. Results After two months of treatment, total clinical response rate of observation group was higher than that of control group (93.33% vs 70.00%, P < 0.05). After two months of treatment, levels of BUN, 24 h urinary protein quantification, urinary microalbumin, FBG, 2hPG, HbA1c, IL-6, IL-8 and TNF-α were decreased in both groups, which were lower in observation group than control group (P < 0.05). During treatment, there was no significant difference in the incidence of adverse reactions between observation group and control group (13.33% vs 10.00%, P > 0.05). Conclusion Clinical curative effect of papaverine combined with Piperazine Ferulate Tablet is good in patients with DN, which can effectively control blood glucose, relieve inflammatory response and improve renal function, with low incidence of adverse reactions.

R969.4