目的 探讨十味诃子丸联合阿魏酸哌嗪治疗慢性肾小球肾炎的临床疗效。方法 选取2021年1月—2023年3月南京医科大学附属江苏盛泽医院收治的136例慢性肾小球肾炎患者，按数字随机法将患者分对照组（68例）和治疗组（68例）。对照组患者口服阿魏酸哌嗪片，200 mg/次，3次/d。在对照组基础上，治疗组口服十味诃子丸，4丸/次，3次/d。两组患者治疗28 d。观察两组患者临床疗效，比较治疗前后两组患者症状缓解时间，肾功能指标尿素氮（BUN）、血清肌酐（SCr）、24 h尿蛋白量（24 h Upro），血清炎性因子白细胞介素-6（IL-6）、血管内皮生长因子（VEGF）、肿瘤坏死因子-α（TNF-α）、基质金属蛋白酶-9（MMP-9）水平及不良反应。结果 治疗后，治疗组总有效率为98.53%，明显高于对照组总有效率（85.29%，P＜0.05）。治疗后，治疗组症状缓解时间均明显早于对照组（P＜0.05）。治疗后，两组患者BUN、SCr、24 h Upro、IL-6、TNF-α和VEGF均明显降低，而MMP-9水平明显升高（P＜0.05），且治疗组这些指标均明显好于对照组（P＜0.05）。治疗后，治疗组不良反应总发生率（4.41%）明显低于对照组发生率（10.29%，P＜0.05）。结论 十味诃子丸联合阿魏酸哌嗪治疗慢性肾小球肾炎效果确切，临床症状明显改善，调节肾功能状态，可使炎性反应减弱，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

苏州市科技计划项目（SKJYD2021030，SKY2022032）；苏州市吴江区“科教兴卫”项目（wwk202104，wwk201717）