目的 观察黄葵胶囊联合他克莫司和泼尼松治疗特发性膜性肾病的临床疗效。方法 选择新乡医学院第一附属医院2015年3月—2016年12月就诊的特发性膜性肾病患者86例，随机分为对照组和治疗组，每组各43例。对照组患者餐前1 h口服他克莫司胶囊，0.05 mg/（kg·d），2次/d；同时口服醋酸泼尼松片，30 mg/d。治疗后患者在对照组的基础上口服黄葵胶囊，5粒/次，3次/d。两组患者均连续治疗12周。治疗后，观察两组患者临床疗效，同时比较治疗前后两组患者观察指标和不良反应情况。结果 治疗后，对照组和治疗组的总有效率分别为81.39%、95.35%，两组比较差异具有统计学意义（P< 0.05）。治疗后，两组患者24 h尿蛋白定量和总胆固醇水平显著降低，血清白蛋白明显升高，同组治疗前后比较差异具有统计学意义（P< 0.05）；且治疗组患者上述指标显著优于对照组，两组比较差异具有统计学意义（P< 0.05）。两组不良反应发生情况比较差异无统计学意义。结论 黄葵胶囊联合他克莫司和泼尼松治疗特发性膜性肾病疗效明显，安全性较好，具有一定的临床推广应用价值。

Objective To observe the clinical effect of Huangkui Capsules combined with tacrolimus and prednisone in treatment of idiopathic membranous nephropathy. Methods Patients (86 cases) with idiopathic membranous nephropathy in the First Affiliated Hospital of Xinxiang Medical University from March 2015 to December 2016 were randomly divided into control group and treatment group, and each group had 43 cases. Patients in the control group were po administered with Tacrolimus Capsules 1 h before meals, 0.1 mg/(kg·d), twice daily; And they were po administered with Prednisone Acetate Tablets, 30 mg/d. Patients in the treatment group were po administered with Huangkui Capsules on the basis of the control group, five grains/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and observational indexes and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 81.39% and 95.35% respectively, and there was difference between two groups (P < 0.05). After treatment, the levels of 24 h urine protein and total cholesterol were significantly decreased, but serum albumin was significantly increased, the difference was statistically significant in the same group (P < 0.05). And those indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). There was no significant difference in adverse reactions between two groups.Conclusion Huangkui Capsules combined with tacrolimus and prednisone has a significant curative effect in treatment of idiopathic membranous nephropathy with good safety, which has a certain clinical application value.