目的：观察健脾益肾泄浊汤治疗早期2 型糖尿病肾病的临床疗效及对患者免疫功能的影响。方 法：选择120 例早期2 型糖尿病肾病患者，按随机数字表法分为对照组及健脾组各60 例。对照组采用控制血 糖、血压、服用西药等常规治疗，健脾组在对照组基础上加用健脾益肾泄浊汤治疗，连续治疗60 d。比较 2 组临床疗效，并比较2 组治疗前后肾功能指标[血清胱抑素C（Cys-C）、C-反应蛋白（CRP）、尿白蛋白排出 率（UAER）、内生肌酐清除率（CCr） ]、血清免疫功能指标（CD4+、CD8+）、血清炎症因子[肿瘤坏死因子- α（TNF-α）、白细胞介素-6（IL-6） ]和血管内皮生长因子（VEGF） 水平。结果：治疗后，健脾组总有效率 88.33%，高于对照组71.67% （P＜0.05）。治疗后，2 组Cys-C、CRP、UAER 均下降（P＜0.05），CCr 均升 高（P＜0.05）；且健脾组Cys-C、UAER 低于对照组（P＜0.05），CCr 高于对照组（P＜0.05）。治疗后，2 组 CD4+、CD4+/CD8+水平均下降（P＜0.05），CD8+水平升高（P＜0.05），且健脾组CD4+、CD4+/CD8+水平低于对照 组（P＜0.05）。治疗后，2 组VEGF、TNF-α、IL-6 水平均降低（P＜0.05），且健脾组VEGF、TNF-α 水平低 于对照组（P＜0.05）。结论：健脾益肾泄浊汤在治疗2 型糖尿病肾病方面有较明显的疗效，能够有效改善患者 肾功能指标和免疫功能指标，抑制机体炎症反应，延缓肾损害的进一步发展。
Abstract： Objective： To observe the clinical effect of Jianpi Yishen Xiezhuo Decoction on early type 2 diabetic kidney disease (T2DKD) and its effect on the immunologic function of patients. Methods ： A total of 120 patients with early T2DKD were selected and divided into the control group and the Jianpi group according to the random number table method，with 60 cases in each group. The control group was given the routine treatment， including blood glucose and blood pressure control and administration of western medicine， and the Jianpi group was additionally treated with Jianpi Yishen Xiezhuo Decoction based on the treatment of the control group. Both groups were treated for 60 days. The clinical effects，and the levels of kidney function indexes， including cystatin C (Cys- C)， C- reactive protein (CRP)， urinary albumin excretion rate (UAER) and creatinine clearance rate (CCr)， serum immunologic function indexes， including CD4 + and CD8 + ， serum inflammatory factors， including tumor necrosis factor- α (TNF- α) and interleukin- 6 (IL- 6) and vascular endothelial growth factor (VEGF) were compared before and after treatment between the two groups. Results：After treatment，the total effective rate was 88.33% in the Jianpi group，higher than that of 71.67% in the control group (P＜0.05). After treatment，the levels of Cys- C， CRP and UAER in both groups were decreased (P＜0.05)， and the CCr levels were increased (P＜ 0.05)；the levels of Cys- C and UAER in the Jianpi group were lower than those in the control group (P＜ 0.05)，and the CCr level was higher than that in the control group (P＜0.05). After treatment，the levels of CD4+ and CD4+/CD8+ in both groups were decreased (P＜0.05)，and the CD8+ levels were increased (P＜ 0.05)；the levels of CD4+ and CD4+/CD8+ in the Jianpi group were lower than those in the control group (P＜ 0.05). After treatment， the levels of VEGF， TNF- α and IL- 6 in both groups were decreased (P＜0.05)， and the levels of VEGF and TNF-α in the Jianpi group were lower than those in the control group (P＜0.05). Conclusion： Jianpi Yishen Xiezhuo Decoction has a significant curative effect on early T2DKD disease， which can effectively improve the kidney function indexes and immunologic function of patients，inhibit the inflammatory responses of the body and delay the further progress of renal damage.