目的探讨基层临床药师对糖尿病肾病患者临床用药的指导和预后的影响。方法回顾性选取2012年5月至2014年6月胜利石油管理局滨南医院门诊治疗的老年糖尿病肾病患者86例,按随机数字表法分为观察组和对照组,每组43例。对照组患者采用常规治疗,观察组患者在对照组基础上采用药师干预,评价干预后结果。结果随访3个月时,两组患者用药依从性改善不明显,但观察组干预后与干预前比较,差异有统计学意义(P<0.05),观察组和对照组患者空腹血糖及24 h尿蛋白总量较干预前均有明显改善,差异有统计学意义(P<0.05)。随访6个月时,观察组患者用药依从性较干预前显著提高,差异有统计学意义(P<0.01),观察组较对照组患者用药依从性差异有统计学意义(P<0.05)。两组患者空腹血糖及24 h尿蛋白总量较干预前均有显著改善,差异有统计学意义(P<0.01),而观察组的改善程度优于对照组,差异有统计学意义(P<0.05)。结论通过临床药师对用药的积极干预和指导,患者用药更加科学,并且用药依从性和临床疗效明显提高。 Objective To investigate the effect of primary clinical pharmacists on the guidance and prognosis of patients with diabetic nephropathy. Methods A total of 86 elderly patients with diabetic nephropathy who were treated in Binnan Hospital of Shengli Petroleum Administration from May 2012 to June 2014 were retrospectively selected and divided into observation group and control group according to random number table method, with 43 cases in each group. Patients in the control group were treated with conventional therapy. The patients in the observation group were treated with pharmacists on the basis of the control group, and the results after the intervention were evaluated. Results After 3 months of follow-up, there was no significant improvement in medication adherence between the two groups. However, the difference between the two groups was not significant after the intervention (P <0.05). The fasting blood glucose and 24-hour urine of the observation group and the control group The total amount of protein was significantly improved than before intervention, the difference was statistically significant (P <0.05). Follow-up 6 months, the observation group patients medication compliance than before intervention significantly increased, the difference was statistically significant (P <0.01), the observation group compared with the control group patients medication compliance was statistically significant (P <0.05). The fasting blood glucose and 24 h urinary protein in both groups were significantly improved compared with those before intervention (P <0.01), while the improvement in observation group was better than that in control group (P < 0.05). Conclusion Through clinical pharmacists active intervention and guidance of medication, patients medication more scientific and medication compliance and clinical efficacy significantly improved.