目的 探討大黃䗪蟲丸聯(lián)合他克莫司膠囊治療腎病綜合征的臨床療效。方法 選取2018年5月-2020年3月在天津中醫(yī)藥大學(xué)第一附屬醫(yī)院就診的92例腎病綜合征患者，按照隨機(jī)數(shù)字表法將92例患者分為治療組和對照組，每組各有46例。對照組口服他克莫司膠囊，0.05 mg/（kg·d），2次/d。治療組在對照組治療的基礎(chǔ)上口服大黃䗪蟲丸，6 g/次，2次/d。兩組治療8周。比較兩組的總有效率及24 h尿蛋白定量轉(zhuǎn)陰時間、浮腫消失時間、尿量恢復(fù)時間，檢測兩組患者治療前后血液流變學(xué)指標(biāo)（血漿黏度、D-二聚體、纖維蛋白原）和腎功能指標(biāo)[血清白蛋白、24 h尿蛋白定量、肌酐（Scr）]水平。結(jié)果 治療后，治療組患者的總有效率（93.48%）高于對照組（78.26%），差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，治療組的24 h尿蛋白定量轉(zhuǎn)陰時間、浮腫消失時間、尿量恢復(fù)時間均低于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組血漿黏度、D-二聚體、纖維蛋白原水平均顯著低于治療前（P<0.05）；治療后，治療組的血漿黏度、D-二聚體、纖維蛋白原水平比對照組低（P<0.05）。治療后，兩組血清白蛋白水平顯著升高，24 h尿蛋白定量、Scr水平顯著降低（P<0.05）；治療后，治療組的血清白蛋白水平比對照組高，24 h尿蛋白定量、Scr水平比對照組低（P<0.05）。結(jié)論 大黃䗪蟲丸聯(lián)合他克莫司膠囊治療腎病綜合征的臨床療效明確，可促進(jìn)癥狀的恢復(fù)，改善血液流變學(xué)和腎功能，具有良好臨床使用價值。

Objective To explore the clinical effect of Dahuang Zhechong Pills combined with Tacrolimus Capsules in treatment of nephrotic syndrome. Methods Patients (92 cases) with nephrotic syndrome in the First Teaching Hospital of Tianjin University of TCM from May 2018 to March 2020 were randomly divided into control and treatment groups, and each group had 46 cases. Patients in the control group were po administered with Tacrolimus Capsules, 0.05 mg/(kg·d), twice daily. Patients in the treatment group were po administered with Dahuang Zhechong Pills on the basis of the control group, 6 g/time, twice daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacies were evaluated, and 24 h urine protein quantitation negative time, edema disappearance time and urine volume recovery in two groups were compared. The hemorheology indexes (plasma viscosity, D-dimer, fibrinogen) and renal function indexes (albumin, urinary protein, Scr) were measured before and after treatment. Results After treatment, the total effective rate of the treatment group (93.48%) was higher than that of the control group (78.26%), and the difference was statistically significant (P<0.05). After treatment, 24 h urine protein quantitation negative time, edema disappearance time and urine volume recovery in the treatment group were shorter than those in the control group, and the difference was statistically significant (P<0.05). After treatment, the plasma viscosity, D-dimer and fibrinogen in the two groups were significantly lower than those before treatment (P<0.05). After treatment, the plasma viscosity, D-dimer and fibrinogen of the treatment group were lower than those of the control group (P<0.05). After treatment, the serum levels of albumin in two groups were significantly increased, but the levels of urinary protein and Scr in two groups were significantly decreased (P<0.05). After treatment, the serum levels of albumin in the treatment group was higher than that of the control group, and the levels of the urine protein and Scr in the treatment group were lower than that of the control group, the difference was statistically significant (P<0.05). Conclusion Dahuang Zhezhong Pills combined with Tacrolimus Capsules has clinical curative effect in treatment of nephrotic syndrome, can promote the recovery of symptoms, improve hemorheology and renal function, which has a good clinical value.

R983

國家自然科學(xué)基金資助項目（81373609）