目的 探討尿毒清顆粒聯(lián)合乙酰半胱氨酸治療慢性腎臟病的臨床療效。方法 選取2016年9月—2019年2月在南京醫(yī)科大學(xué)第二附屬醫(yī)院診治的120例慢性腎臟病患者作為研究對(duì)象，根據(jù)隨機(jī)數(shù)字表法將患者均分為對(duì)照組和觀察組，每組各60例。對(duì)照組靜脈滴注乙酰半胱氨酸注射液，40 mL用5%葡萄糖注射液250 mL稀釋，1次/d。觀察組在對(duì)照組治療的基礎(chǔ)上給予尿毒清顆粒，1袋/次，用溫開(kāi)水沖服，3次/d。兩組均治療觀察1個(gè)月。觀察兩組患者的臨床療效，同時(shí)比較兩組治療前后的降鈣素原（PCT）、尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）、血清尿素氮（BUN）、血肌酐（Scr）水平，以及患者不良反應(yīng)發(fā)生情況。結(jié)果 治療后，觀察組的總有效率為98.3%，顯著高于對(duì)照組的88.3%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組治療后的血清PCT、尿NAG水平都顯著低于治療前，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且觀察組治療后血清PCT、尿NAG水平均顯著低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組治療后的血清BUN與Scr水平都顯著低于治療前，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；觀察組BUN和Scr水平均顯著低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀察組治療期間的頭暈、頭痛和干咳等不良反應(yīng)發(fā)生率為3.3%，顯著低于對(duì)照組的16.7%（P<0.05）。結(jié)論 尿毒清顆粒聯(lián)合乙酰半胱氨酸治療慢性腎臟病具有較好的臨床療效，能抑制PCT，降低尿NAG的水平，同時(shí)促進(jìn)腎功能的恢復(fù)，減少不良反應(yīng)的發(fā)生，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effects of Niaoduqing Granules combined with acetylcysteine in treatment of chronic kidney disease. Methods Patients (120 cases) with chronic kidney disease in the Second Affiliated Hospital of Nanjing Medical University from September 2016 to February 2019 were divided into control and observation group accorded to the random number table method, and each group had 60 cases. Patients in the control group were iv administered with Acetylcysteine Injection, 40 mL was diluted with 5% glucose injection 250 mL, once daily. Patients in the observation group were po administered with Niaoduqing Granules on the basis of control group, 1 bag/time, and washed with warm water for 3 times daliy. Both groups were observed for 1 month. After treatment, the clinical efficacy in two groups was observed, and the levels of PCT, NAG, BUN, and Scr before and after treatment were compared, and the incidence of adverse reactions during the treatment were compared. Results After treatment, the total effective rate in the observation group was 98.3%, which was significantly higher than 88.3% in the control group, and the difference between two groups was statistically significant (P<0.05). After treatment, the levels of serum PCT and urinary NAG in two groups were significantly lower than those before treatment, the difference before and after treatment in the same group was statistically significant (P<0.05). After treatment, serum PCT and urine NAG levels in the observation group were significantly lower than those in the control group, and the differences between two groups were statistically significant (P<0.05). After treatment, the levels of serum BUN and Scr in two groups were significantly lower than those before treatment, the difference before and after treatment in the same group was statistically significant (P<0.05). After treatment, the levels of BUN and Scr in the observation group were significantly lower than those in the control group, and the difference between two groups was statistically significant (P<0.05). The incidence of adverse reactions such as dizziness, headache and dry cough was 3.3% in the observation group, which was significantly lower than 16.7% in the control group (P<0.05). Conclusion Niaoduqing Granules combined with acetylcysteine in treatment of chronic kidney disease has a good clinical effect, can inhibit PCT, reduce the level of urinary NAG, promote the recovery of renal function, and reduce the occurrence of adverse reactions, has a certain clinical promotion and application value.

R983

江蘇省第五期“333工程”培養(yǎng)資助項(xiàng)目（BRA2018170）