目的 探讨地黄叶总苷胶囊联合羟苯磺酸钙分散片治疗肾病综合征的临床疗效。方法 选取2016年7月-2017年8月山东省泰山医院治疗的92例肾病综合征患者为研究对象，根据随机区组设计法将所有患者分为对照组和治疗组，每组各46例。对照组患者口服羟苯磺酸钙分散片，0.5 g/次，3次/d。治疗组在对照组治疗基础上口服地黄叶总苷胶囊，2粒/次，2次/d。两组患者均持续治疗2个月。观察两组临床疗效，同时比较治疗前后两组患者的尿液和血清指标、肾脏超声学指标、骨代谢相关指标和炎症指标。结果 治疗后，对照组和治疗组的总有效率分别为76.1%、93.5%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组24 h尿蛋白（24 h Upro）、血肌酐（Scr）、尿素氮（BUN）显著降低，血浆白蛋白（Alb）、血肌酐清除率（Ccr）均显著升高，同组治疗前后比较差异具有统计学意义（P<0.05）。治疗后，治疗组24 h Upro、SCr、BUN水平显著低于对照组，Alb、Ccr显著高于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组肾动脉内径（D）、肾动脉收缩期最大血流速（V_max）显著升高，肾动脉阻力指数（RI）显著降低，同组治疗前后比较差异有统计学意义（P<0.05）。治疗后，治疗组肾动脉D、V_max显著高于对照组，RI显著低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组尿DPD/Cr显著升高，血全段甲状旁腺素（iPTH）显著降低，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组尿DPD/Cr和血iPTH水平均显著优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组IL-1、IL-4和TNF-α水平均显著降低，同组治疗前后比较差异具有统计学意义（P<0.05）。治疗后，治疗组炎性指标均显著低于对照组，两组比较差异具有统计学意义（P<0.05）。结论 地黄叶总苷胶囊联合羟苯磺酸钙分散片治疗肾病综合征具有较好的临床疗效，可显著改善肾功能和骨代谢指标，减轻炎性反应，安全性好，具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Calcium Dobesilate Dispersible Tablets combined with Dihuangye Total Glycoside Capsules in treatment of nephrotic syndrome. Methods Patients (92 cases) with nephrotic syndrome in Shandong Provincial Taishan Hospital from July 2016 to August 2017 were divided into control and treatment groups according to randomized block design, and each group had 46 cases. Patients in the control group were po administered with Calcium Dobesilate Dispersible Tablets, 0.5 g/time, three times daily. Patients in the treatment group were po administered with Dihuangye Total Glycoside Capsules on the basis of the control group, 2 grains/time, twice daily. Patients in two groups were treated for 2 months. After treatment, the clinical efficacies were evaluated, and the urine and serum indicators, renal ultrasound indexes, bone metabolism related indexes, and inflammatory markers in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 76.1% and 93.5%, respectively, and there was difference between two groups (P < 0.05). After treatment, 24 h Upro, Scr, and BUN were significantly decreased in two groups, but Alb and Ccr were significantly increased, and there were differences in the same group (P < 0.05). After treatment, 24 h Upro, Scr, and BUN in the treatment group were lower than those in the control group, but Alb and Ccr were higher than those in the control group, and there were differences between two groups (P < 0.05). After treatment, the D, V_max of renal artery were significantly increased in two groups, but RI was significantly decreased, and there were differences in the same group (P < 0.05). After treatment, the D, V_max of renal artery in the treatment group were higher than those in the control group, but RI was lower than those in the control group, and there were differences between two groups (P < 0.05). After treatment, the urine DPD/Cr was significantly increased in two groups, but blood iPTH was significantly decreased, and there were differences in the same group (P < 0.05). After treatment, the urine DPD/Cr and blood iPTH in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the levels of IL-1, IL-4, and TNF-α in two groups were significantly decreased, and there were differences in the same group (P < 0.05). After treatment, the levels of inflammatory markers in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Dihuangye Total Glycoside Capsules combined with Calcium Dobesilate Dispersible Tablets has clinical curative effect in treatment of nephrotic syndrome, can significantly improve renal function and bone metabolism indexes, reduce the inflammatory reaction, with good safety, which has a certain clinical application value.