目的 探讨复方石韦颗粒联合缬沙坦和前列地尔治疗慢性肾小球肾炎的临床疗效。方法 选取2015年6月-2016年4月在陕西省友谊医院肾病科接受治疗的慢性肾小球肾炎患者60例，根据治疗方法的差别分为对照组和治疗组，每组各30例。对照组静脉滴注前列地尔注射液，10 μg加入生理盐水250 mL，1次/d；同时口服缬沙坦胶囊，1粒/次，1次/d。治疗组在对照组的基础上口服复方石韦颗粒，1袋/次，3次/d。两组患者均连续治疗4周。观察两组患者的临床疗效，同时比较治疗前后两组患者的血肌酐（Scr）、尿素氮（BUN）、24 h尿蛋白（24 h Upro）、尿红细胞（RBC）、β2微球蛋白（β2-MG）、组织纤溶酶原激活物（t-PA）、纤溶酶原激活物抑制物-1（PAI-1）、基质金属蛋白酶-9（MMP-9）和血管内皮生长因子（VEGF）水平的变化情况。结果 治疗后，对照组和治疗组的总有效率分别为80.00%、96.67%，两组比较差异有统计学意义（P<0.05）。治疗后，两组的Scr、BUN、24 h Upro、RBC和β2-MG均明显下降，与治疗前比较差异有统计学意义（P<0.05）；治疗组的Scr、BUN、24 h Upro、RBC和β2-MG的降低程度明显优于对照组（P<0.05）。治疗后，两组的PAI-1、MMP-9和VEGF水平均明显降低，t-PA明显升高，与治疗前比较差异有统计学意义（P<0.01）；治疗组PAI-1、MMP-9、VEGF和t-PA的改善程度均优于对照组（P<0.05）。结论 复方石韦颗粒联合缬沙坦和前列地尔治疗慢性肾小球肾炎临床疗效显著，可明显改善患者肾功能和临床症状，具有一定的临床推广应用价值。

Objective To observe the clinical curative effect of Compound Shiwei Granules combined with valsartan and alprostadil in treatment of chronic glomerulonephritis. Methods Patients (60 cases) with chronic glomerulonephritis in Department of Nephropathy of Shaanxi Friendship Hospital from June 2015 to April 2016 were divided into control and treatment groups according to different treatments, and each group had 30 cases. The patients in the control group were iv administered with Alprostadil Injection, 10 μg added into normal saline 250 mL, once daily, and were po administered with Valsartan Capsules, 1 grain/time, once daily. The patients in the treatment group were po administered with Compound Shiwei Granules on the basis of the control group, 1 bag/time, three times daily. The patients in two groups were treated for 4 weeks. After treatment, the efficacy was evaluated, and the changes of Scr, BUN, 24 h Upro, RBC, β2-MG, t-PA, PAI-1, MMP-9, and VEGF in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 80.00% and 96.67%, respectively, and there were differences between two groups (P<0.05). After treatment, Scr, BUN, 24 h Upro, RBC, and β2-MG in two groups were obviously decreased, and the difference was statistically significant (P<0.05). And the reducing degrees in treatment group were better than those in the control group, with significant difference between two groups (P<0.05). After treatment, PAI-1, MMP-9, and VEGF in two groups were significantly decreased, t-PA was obviously increased, and the difference was statistically significant (P<0.05). And PAI-1, MMP-9, VEGF, and t-PA in the treatment group improved better than those in the control group, with significant differences between two groups (P<0.05). Conclusion Compound Shiwei Granules combined with valsartan and alprostadil has a good clinical curative effect in treatment of chronic glomerulonephritis, can significantly improve the renal function and clinical symptoms, which has a certain clinical application value.