目的 探討黃蛭益腎膠囊聯(lián)合阿魏酸哌嗪片治療慢性腎小球腎炎的臨床療效。方法 選取2018年3月-2019年3月在漯河市中心醫(yī)院治療的94例慢性腎小球腎炎患者為研究對象，根據(jù)用藥的差別分為對照組（47例）和治療組（47例）。對照組患者口服阿魏酸哌嗪片，200 mg/次，3次/d；治療組在對照組基礎上口服黃蛭益腎膠囊，5粒/次，3次/d。兩組均經(jīng)28 d治療。觀察兩組患者臨床療效，同時比較治療前后兩組患者24 h尿蛋白定量（24 h UPR）、血肌酐（Scr）、血尿素氮（BUN）和尿RBC，血清可溶性血管內(nèi)皮細胞生長因子受體-1（sFIt-1）、溶酶體相關膜蛋白2（LAMP-2）、纖維蛋白溶解酶原激活物抑制劑-1（PAI-1）、白細胞介素-17（IL-17）、外周單個核細胞B7-1、重組組織型纖溶酶原激活物（t-PA）水平，以及APACHE Ⅱ、PSQI和SF-36評分。結果 治療后，對照組和治療組臨床有效率分別為80.85%和97.87%，兩組比較差異有統(tǒng)計學意義（P<0.05）。治療后，兩組患者24 h UPR、Scr、BUN和尿RBC均顯著降低（P<0.05），且治療組患者24 h UPR、Scr、BUN和尿RBC顯著低于對照組（P<0.05）。治療后，兩組患者血清sFIt-1、LAMP-2、PAI-1、IL-17、B7-1水平均顯著下降（P<0.05），而t-PA水平顯著升高（P<0.05），且治療組患者這些細胞因子水平顯著好于對照組（P<0.05）。治療后，兩組患者APACHE Ⅱ評分、PSQI評分均明顯降低（P<0.05），而SF-36評分明顯升高（P<0.05），且治療組患者APACHE Ⅱ、PSQI和SF-36評分明顯好于對照組（P<0.05）。結論 黃蛭益腎膠囊聯(lián)合阿魏酸哌嗪片治療慢性腎小球腎炎效果顯著，可有效改善患者腎功能，提高患者生活質(zhì)量，促進患者睡眠質(zhì)量提高。

Objective To investigate the clinical efficacy of Huangzhi Yishen Capsules combined with piperazine ferulate in treatment of chronic glomerulonephritis. Methods Patients (94 cases) with chronic glomerulonephritis in Luohe Central Hospital from March 2018 to March 2019 were divided into control (47 cases) and treatment (47 cases) groups based on different treatments. Patients in the control group were po administered with Piperazine Ferulate Tablets, 200 mg/time, three times daily. Patients in the treatment group were po administered with Huangzhi Yishen Capsules on the basis of the control group, 5 grains/times, three times daily. Patients in two groups were treated for 28 d. After treatment, the clinical efficacy was evaluated, and the 24 h UPR, Scr, BUN, RBC, and serum levels of sFIt-1, LAMP-2, PAI-1, IL-17, B7-1, t-PA, and APACHE Ⅱ, PSQI, and SF-36 scores in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 80.85% and 97.87%, respectively, and there were differences between two groups (P<0.05). After treatment, the 24 h UPR, Scr, BUN and RBC in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the serum levels of sFIt-1, LAMP-2, PAI-1, IL-17, B7-1 in two groups were significantly decreased (P<0.05), but t-PA levels were significantly increased (P<0.05), and these serum cytokines in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the APACHE Ⅱ and PSQI scores in two groups were significantly decreased (P<0.05), but SF-36 scores were significantly increased (P<0.05), and these scores in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Huangzhi Yishen Capsules combined with piperazine ferulate in treatment of chronic glomerulonephritis has significant effect, which can effectively improve the renal function, and improve the quality of life and sleep of patients.

R983