目的 觀察百令膠囊聯(lián)合羥氯喹治療原發(fā)性IgA腎病的臨床療效。方法 選取2019年8月—2021年7月寶雞市中醫(yī)醫(yī)院收治的92例原發(fā)性IgA腎病患者，按隨機(jī)數(shù)字表法分為對照組和治療組，每組各46例。對照組進(jìn)餐時(shí)口服硫酸羥氯喹片，0.2 g/次，2次/d。治療組在對照組基礎(chǔ)上口服百令膠囊，4粒/次，3次/d。兩組療程均為12周。觀察兩組的臨床療效，比較治療前后兩組主要癥狀積分、腎功能指標(biāo)以及血清白細(xì)胞介素（IL）-17、IL-23、單核細(xì)胞趨化蛋白-1（MCP-1）、轉(zhuǎn)化生長因子-β1（TGF-β1）和基質(zhì)金屬蛋白酶-9（MMP-9）水平。結(jié)果 治療后，治療組總有效率為95.7%，顯著高于對照組82.6%（P＜0.05）。治療后兩組血尿、泡沫尿、面浮肢腫、腰膝酸軟積分均顯著降低（P＜0.05）；且治療后，治療組以上各項(xiàng)癥狀積分均顯著低于對照組（P＜0.05）。治療后，兩組24 h尿蛋白定量（24 h UP）和血清肌酐（Cr）、尿素氮（BUN）水平均較治療前顯著下降（P＜0.05）；且均以治療組的改善更顯著（P＜0.05）。治療后兩組血清IL-17、IL-23、MCP-1、TGF-β1和MMP-9水平均顯著降低（P＜0.05）；且均以治療組的下降更顯著（P＜0.05）。結(jié)論 百令膠囊聯(lián)合羥氯喹治療原發(fā)性IgA腎病的整體療效確切，能有效緩解患者臨床癥狀，保護(hù)腎功能，并可進(jìn)一步下調(diào)體內(nèi)IL-17、IL-23、MCP-1、TGF-β1和MMP-9水平，從而利于減輕患者機(jī)體炎性損傷，抑制組織纖維化，且安全性較好。

Objective To observe the clinical efficacy of Bailing Capsules combined with hydroxychloroquine in treatment of primary IgA nephropathy. Methods A total of 92 patients with primary IgA nephropathy admitted to Baoji Hospital of Traditional Chinese Medicine from August 2019 to July 2021 were selected and divided into control group and treatment group according to random number table method, with 46 cases in each group. Patients in the control group were po administered with Hydroxychloroquine Sulfate Tablets with meals, 0.2 g/time, twice daily. Patients in the treatment group were po administered with Bailing Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the main symptom scores, renal function indexes, serum interleukin (IL)-17, IL-23, monocyte chemoattractant protein-1 (MCP-1), transforming growth factor-β1 (TGF-β1), and matrix metalloproteinase-9 (MMP-9) levels were compared between the two groups before and after treatment. Results After treatment, the total effective rate of treatment group was 95.7%, which was significantly higher than that of control group 82.6% (P < 0.05). After treatment, the scores of hematuria, foaming urine, floating face and swollen limbs, waist and knee tenderness were significantly decreased (P < 0.05). After treatment, the scores of the above symptoms in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, 24 h UP, serum Cr and BUN levels in both groups were significantly decreased compared with those before treatment (P < 0.05). The improvement was more significant in the treatment group (P < 0.05). After treatment, serum levels of IL-17, IL-23, MCP-1, TGF-β1 and MMP-9 were significantly decreased in both groups (P < 0.05). The decrease was more significant in the treatment group (P < 0.05). Conclusion Bailing Capsules combined with hydroxychloroquine has a definite overall curative effect in treatment of primary IgA nephropathy, and can effectively relieve the clinical symptoms of patients, protect renal function, and further down-regulate IL-17, IL-23, MCP-1, TGF-β1 and MMP-9. Therefore, it is beneficial to reduce the inflammatory injury of the patient, inhibit the tissue fibrosis, and the safety is good.

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