目的 探討十味訶子丸聯(lián)合阿魏酸哌嗪治療慢性腎小球腎炎的臨床療效。方法 選取2021年1月—2023年3月南京醫(yī)科大學附屬江蘇盛澤醫(yī)院收治的136例慢性腎小球腎炎患者，按數(shù)字隨機法將患者分對照組（68例）和治療組（68例）。對照組患者口服阿魏酸哌嗪片，200 mg/次，3次/d。在對照組基礎上，治療組口服十味訶子丸，4丸/次，3次/d。兩組患者治療28 d。觀察兩組患者臨床療效，比較治療前后兩組患者癥狀緩解時間，腎功能指標尿素氮（BUN）、血清肌酐（SCr）、24 h尿蛋白量（24 h Upro），血清炎性因子白細胞介素-6（IL-6）、血管內皮生長因子（VEGF）、腫瘤壞死因子-α（TNF-α）、基質金屬蛋白酶-9（MMP-9）水平及不良反應。結果 治療后，治療組總有效率為98.53%，明顯高于對照組總有效率（85.29%，P＜0.05）。治療后，治療組癥狀緩解時間均明顯早于對照組（P＜0.05）。治療后，兩組患者BUN、SCr、24 h Upro、IL-6、TNF-α和VEGF均明顯降低，而MMP-9水平明顯升高（P＜0.05），且治療組這些指標均明顯好于對照組（P＜0.05）。治療后，治療組不良反應總發(fā)生率（4.41%）明顯低于對照組發(fā)生率（10.29%，P＜0.05）。結論 十味訶子丸聯(lián)合阿魏酸哌嗪治療慢性腎小球腎炎效果確切，臨床癥狀明顯改善，調節(jié)腎功能狀態(tài)，可使炎性反應減弱，且安全有效。

Objective To explore the clinical study of Shiwei Hezi Pills combined with piperazine ferulate in treatment of chronic glomerulonephritis. Methods A total of 136 patients with chronic glomerulonephritis admitted to Jiangsu Shengze Hospital Affiliated to Nanjing Medical University from January 2021 to March 2023 were selected and divided into control group (68 cases) and treatment group (68 cases) according to numerical random method. 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 Shiwei Hezi Pills on the basis of the control group, 4 pills/time, three times daily. Patients in two groups were treated for 28 d. After treatment, the clinical evaluation was evaluated, and the symptom relief times, the levels of BUN, SCr, 24 h urine, IL-6, TNF-α, VEGF and MMP-9, and adverse reaction in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 98.53%, which was significantly higher than that of the control group (85.29%, P < 0.05). After treatment, the relief time of symptom in the treatment group was significantly earlier than that in the control group (P < 0.05). After treatment, the indexes of BUN, SCr, 24 h Upro, IL-6, TNF-α and VEGF in two groups were significantly decreased, while the level of MMP-9 were significantly increased (P < 0.05), and these indexes in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the incidence of adverse events in the treatment group (4.41%) was significantly lower than that in the control group (10.29%, P < 0.05). Conclusion Piperazine ferulate combined with Shiwei Hezi Pills has a definite therapeutic effect, can obviously improve the clinical symptoms, regulate the state of renal function, weaken the inflammatory reaction, and is safe and effective.

R983

蘇州市科技計劃項目（SKJYD2021030，SKY2022032）；蘇州市吳江區(qū)“科教興衛(wèi)”項目（wwk202104，wwk201717）