目的 探討黃葵膠囊聯(lián)合嗎替麥考酚酯治療IgA腎病的臨床效果。方法 選取2015年3月—2018年3月四川省甘孜州人民醫(yī)院收治的IgA腎病患者81例，隨機(jī)分成對照組（40例）和治療組（41例）。對照組餐后2 h口服嗎替麥考酚酯膠囊，3粒/次，2次/d。治療組在對照組基礎(chǔ)上餐后30 min口服黃葵膠囊，5粒/次，3次/d。兩組均連續(xù)治療12周。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 UPQ）、尿沉渣紅細(xì)胞（RBC）計數(shù)、血清肌酐（Cr）、腎小球濾過率（eGFR）值、超敏C反應(yīng)蛋白（hs-CRP）、白介素-6（IL-6）、免疫球蛋白A（IgA）、補(bǔ)體C3、IgA/C3水平。結(jié)果 治療后，對照組和治療組臨床有效率分別為75.0%、92.7%，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組24 h UPQ、尿沉渣RBC計數(shù)和血清Cr水平較治療前均顯著降低（P<0.05），eGFR值顯著升高（P<0.05），且治療組這些腎功能相關(guān)指標(biāo)明顯優(yōu)于對照組（P<0.05）。治療后，兩組血清hs-CRP、IL-6、IgA水平和IgA/C3比值均顯著下降（P<0.05），血清補(bǔ)體C3濃度顯著上升（P<0.05），且治療組hs-CRP、IL-6、IgA、補(bǔ)體C3、IgA/C3水平明顯優(yōu)于對照組（P<0.05）。結(jié)論 黃葵膠囊聯(lián)合嗎替麥考酚酯治療IgA腎病可明顯改善患者腎功能，減輕炎性損傷，下調(diào)血中IgA表達(dá)水平，抑制補(bǔ)體系統(tǒng)異常激活，延緩腎臟損傷。

Objective To investigate the clinical effect of Huangkui Capsules combined with mycophenolate mofetil in treatment of IgA nephropathy. Methods Patients (81 cases) with IgA nephropathy in Ganzi Tibetan Autonomous Prefecture People's Hospital from March 2015 to March 2018 were randomly divided into control (40 cases) and treatment (41 cases) groups. Patients in the control group were po administered with Mycophenolate Mofetil Capsules, 3 grains/time, twice daily. Patients in the treatment group were po administered with Huangkui Capsules on the basis of the control group, 5 grains/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the 24 h UPQ, RBC count, serum Cr, eGFR value, hs-CRP, IL-6, Ig A, complement C3, IgA/C3 levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 75.0% and 92.7% respectively, and there were differences between two groups (P<0.05). After treatment, the 24 h UPQ, RBC count of urinary sediment and serum Cr levels in two groups were significantly decreased (P<0.05), but eGFR value was significantly increased (P<0.05), and these renal function related indicators in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the serum hs-CRP, IL-6, IgA and IgA/C3 in two groups were significantly decreased (P<0.05), but complement C3 concentration was significantly increased (P<0.05), and these indicators in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Huangkui Capsules combined with mycophenolate mofetil in treatment of IgA nephropathy can significantly improve renal function, reduce inflammatory injury, down-regulate IgA expression, inhibit abnormal activation of complement system, delay kidney damage.