目的 探讨地黄叶总苷胶囊联合他克莫司治疗肾病综合征的临床效果。方法 选取2016年6月-2018年9月天津医科大学第二医院收治的肾病综合征患者96例，随机分成对照组（48例）和治疗组（48例）。对照组口服他克莫司胶囊，0.05 mg/（kg·d），2次/d。治疗组在对照组基础上口服地黄叶总苷胶囊，2粒/次，2次/d。两组患者均连续治疗2个月。观察两组患者临床疗效，同时比较治疗前后两组患者尿蛋白定量（UTP）值、血清总胆固醇（TC）、肌酐（Cr）、尿素氮（BUN）和白蛋白（ALB）水平及炎症指标水平和免疫功能指标。结果 治疗后，对照组和治疗组临床总有效率分别为79.2%、93.8%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者UTP值及血清TC、Cr、BUN水平均显著降低（P<0.05），血清ALB浓度均显著上升（P<0.05），且治疗组患者UTP值、血清TC、Cr、BUN水平及ALB浓度明显好于对照组（P<0.05）。治疗后，两组患者血清白介素-4（IL-4）、C反应蛋白（CRP）水平显著降低（P<0.05），且治疗组患者IL-4、CRP水平明显低于对照组（P<0.05）。治疗后，两组患者血清IgG、补体C3水平及外周血CD4⁺/CD8⁺比值均显著升高（P<0.05），且治疗组患者免疫功能明显好高于对照组（P<0.05）。结论 地黄叶总苷胶囊联合他克莫司治疗肾病综合征的疗效显著，能有效缓解患者病情，控制蛋白尿，保护肾功能。

Objective To investigate the clinical effect of Dihuangye Zonggan Capsules combined with tachmoth in treatment of nephrotic syndrome. Methods Patients (96 cases) with nephrotic syndrome in the Second Hospital of Tianjin Medical University from June 2016 to September 2018 were randomly divided into control (48 cases) and treatment (48 cases) groups. Patients in the control group were po administered with Tacrolimus Capsules, 0.05 mg/(kg·d), twice daily. Patients in the treatment group were po administered with Dihuangye Zonggan 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 efficacy was evaluated, and the UTP value, serum levels of TC, Cr, BUN, ALB, and inflammatory indicators levels, immune function indicators levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 79.2% and 93.8% respectively, and there were differences between two groups (P<0.05). After treatment, the UTP value, serum levels of TC, Cr, BUN in two groups were significantly decreased (P<0.05), serum concentration of ALB was 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 serum IL-4 and CRP levels in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the serum IgG value, complement C3 level and CD4⁺/CD8⁺ value of peripheral blood in two groups were significantly increased (P<0.05), and the immune function in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Dihuangye Zonggan Capsules combined with tachmoth in treatment of nephrotic syndrome has significant clinical effect, which can effectively relieve the patient's condition, control proteinuria, protect renal function.

R983