目的:探讨雷公藤提取物对糖尿病肾病(DN)患者T淋巴细胞及尿微量蛋白的影响。方法:以广东省潮州市潮安区人民医院糖尿病科2013年4月-2016年7月符合纳入标准的DN患者92例为研究对象,随机分为对照组和研究组各46例,对照组予缬沙坦治疗;研究组在缬沙坦治疗基础上予雷公藤多苷片治疗,治疗3个月为一疗程。比较治疗前后血清T淋巴细胞、血管内皮功能、氧化应激及实验室相关指标、临床疗效及不良反应。结果:与治疗前比较,两组治疗后CD3~+、CD8~+升高,CD4~+、CD4~+/CD8~+降低,治疗后血清VECF、s ICAM-1、ET-1含量降低,治疗后血清Cys-C、β2-MG、Cr、SBP、DBP和尿24h-UMA含量降低,血清ROS、MDA降低,SOD升高(P<0.05);与对照组比较,研究组治疗后CD3~+、CD8~+较高,CD4~+、CD4~+/CD8~+较低,治疗后血清VECF、s ICAM-1、ET-1含量较低,治疗后血清Cys-C、β2-MG、Cr、SBP、DBP和尿24h-UMA含量较低,治疗后血清ROS、MDA较低,SOD较高(P<0.05);研究组有效率明显高于对照组(91.3%vs 73.9%,P<0.05);两组间不良反应率无明显差异(P>0.05)。结论:雷公藤多苷片对DN疗效确切,调节T淋巴细胞,降低尿微量蛋白,安全性高。 Objective: To investigate the effect of tripterygium wilfordii extract on T lymphocytes and urinary microalbuminuria in patients with diabetic nephropathy (DN). Methods: Ninety-two patients with DN who met the inclusion criteria were enrolled in this study from April 2012 to July 2016 in Department of Diabetes, Chaoan People’s Hospital, Chaozhou, Guangdong Province. The patients were randomly divided into control group and study group with 46 cases in each. Control group Valsartan treatment; the study group in the valsartan treatment based on tripterygium glycosides tablets treatment, treatment for 3 months as a course of treatment. Serum T lymphocytes, vascular endothelial function, oxidative stress and laboratory related indexes, clinical efficacy and adverse reactions were compared before and after treatment. Results: The levels of CD3 +, CD8 +, CD4 +, CD4 + / CD8 + decreased after treatment in both groups. After treatment, the levels of VECF, s ICAM-1 and ET- Serum levels of Cys-C, β2-MG, Cr, SBP, DBP and urine 24h-UMA decreased after treatment, serum ROS and MDA decreased and SOD increased (P <0.05); Compared with the control group, The levels of serum Cys-C, β2-MG, Cys-C, Cys-C, The levels of serum Cr, SBP, DBP and urinary 24h-UMA were lower than those of the control group (91.3% vs 73.9%, P < 0.05). There was no significant difference in adverse reactions between the two groups (P> 0.05). Conclusion: Tripterygium glycosides tablets have definite effect on DN, regulate T lymphocytes, reduce the microalbuminuria and have high safety.