目的 探讨黄蛭益肾胶囊联合阿魏酸哌嗪片治疗慢性肾小球肾炎的临床疗效。方法 选取2018年3月-2019年3月在漯河市中心医院治疗的94例慢性肾小球肾炎患者为研究对象，根据用药的差别分为对照组（47例）和治疗组（47例）。对照组患者口服阿魏酸哌嗪片，200 mg/次，3次/d；治疗组在对照组基础上口服黄蛭益肾胶囊，5粒/次，3次/d。两组均经28 d治疗。观察两组患者临床疗效，同时比较治疗前后两组患者24 h尿蛋白定量（24 h UPR）、血肌酐（Scr）、血尿素氮（BUN）和尿RBC，血清可溶性血管内皮细胞生长因子受体-1（sFIt-1）、溶酶体相关膜蛋白2（LAMP-2）、纤维蛋白溶解酶原激活物抑制剂-1（PAI-1）、白细胞介素-17（IL-17）、外周单个核细胞B7-1、重组组织型纤溶酶原激活物（t-PA）水平，以及APACHE Ⅱ、PSQI和SF-36评分。结果 治疗后，对照组和治疗组临床有效率分别为80.85%和97.87%，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者24 h UPR、Scr、BUN和尿RBC均显著降低（P<0.05），且治疗组患者24 h UPR、Scr、BUN和尿RBC显著低于对照组（P<0.05）。治疗后，两组患者血清sFIt-1、LAMP-2、PAI-1、IL-17、B7-1水平均显著下降（P<0.05），而t-PA水平显著升高（P<0.05），且治疗组患者这些细胞因子水平显著好于对照组（P<0.05）。治疗后，两组患者APACHE Ⅱ评分、PSQI评分均明显降低（P<0.05），而SF-36评分明显升高（P<0.05），且治疗组患者APACHE Ⅱ、PSQI和SF-36评分明显好于对照组（P<0.05）。结论 黄蛭益肾胶囊联合阿魏酸哌嗪片治疗慢性肾小球肾炎效果显著，可有效改善患者肾功能，提高患者生活质量，促进患者睡眠质量提高。

Objective To investigate the clinical efficacy of Huangzhi Yishen Capsules combined with piperazine ferulate in treatment of chronic glomerulonephritis. Methods Patients (94 cases) with chronic glomerulonephritis in Luohe Central Hospital from March 2018 to March 2019 were divided into control (47 cases) and treatment (47 cases) groups based on different treatments. 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 Huangzhi Yishen Capsules on the basis of the control group, 5 grains/times, three times daily. Patients in two groups were treated for 28 d. After treatment, the clinical efficacy was evaluated, and the 24 h UPR, Scr, BUN, RBC, and serum levels of sFIt-1, LAMP-2, PAI-1, IL-17, B7-1, t-PA, and APACHE Ⅱ, PSQI, and SF-36 scores in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 80.85% and 97.87%, respectively, and there were differences between two groups (P<0.05). After treatment, the 24 h UPR, Scr, BUN and RBC 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 levels of sFIt-1, LAMP-2, PAI-1, IL-17, B7-1 in two groups were significantly decreased (P<0.05), but t-PA levels were significantly increased (P<0.05), and these serum cytokines in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the APACHE Ⅱ and PSQI scores in two groups were significantly decreased (P<0.05), but SF-36 scores were significantly increased (P<0.05), and these scores in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Huangzhi Yishen Capsules combined with piperazine ferulate in treatment of chronic glomerulonephritis has significant effect, which can effectively improve the renal function, and improve the quality of life and sleep of patients.

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