目的 探討骨化三醇膠丸聯(lián)合氯沙坦鉀治療糖尿病腎病的臨床療效。方法 選取2014年4月—2016年1月天津市第二醫(yī)院收治的糖尿病腎病患者120例，隨機(jī)分為對(duì)照組和治療組，每組各60例。兩組患者均給予運(yùn)動(dòng)和飲食控制指導(dǎo)，并口服降糖藥物控制血糖。對(duì)照組患者口服氯沙坦鉀片，起始劑量為25 mg/次，1次/d，根據(jù)耐受情況可逐漸調(diào)整至50 mg/d。治療組在對(duì)照組的基礎(chǔ)上口服骨化三醇膠丸，1粒/次，1次/d。兩組患者均持續(xù)治療3個(gè)月。觀察兩組患者臨床療效，同時(shí)比較兩組治療前后腎功能相關(guān)指標(biāo)、炎性因子水平變化情況。結(jié)果 治療后，對(duì)照組和治療組總有效率分別為75.00%、90.00%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者24 h尿蛋白量、UAER、Scr、TNF-α、hs-CRP和IL-6水平均顯著降低，同組治療前后差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組上述觀察指標(biāo)降低更明顯，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 骨化三醇膠丸聯(lián)合氯沙坦鉀用于治療糖尿病腎病具有顯著的臨床療效，能夠降低蛋白尿水平，并能減輕炎癥反應(yīng)，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical efficacies of Calcitriol Soft Capsules combined with losartan in treatment of diabetic nephropathy. Methods Patients (120 cases) with diabetic nephropathy in Tianjin Second Hospital Selected from April 2014 to Janurary 2016 were randomly divided into control group and treatment group, and each group had 60 cases. All patients were given exercise and diet control guidance, and were po administered with hypoglycemic drugs to control blood sugar. The patients in the control group were po administered with Losartan Potassium Tablets, 25 mg/time as initial dosage, once daily, and which was gradually adjusted to 50 mg/d according to the different tolerance. The patients in the treatment group were po administered with Calcitriol Soft Capsules on the basis of control group, 1 grain/time, once daily. The patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and the changes of renal function indexes and inflammatory factors levels before and after treatment in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 75.00% and 90.00%, respectively, and there were differences between two groups (P<0.05). After treatment, 24 h urinary protein, UAER, Scr, TNF-α, hs-CRP and IL-6 levels were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And these observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Calcitriol capsules combined with losartan in treatment of diabetic nephropathy has a significant clinical efficacy, can reduce the proteinuria levels in urine and inflammatory reaction, which has a certain clinical application value.