目的 分析金水宝片联合卡托普利治疗慢性肾功能衰竭的临床疗效。方法 选取2020年12月—2023年8月南通市中医院收治的116例慢性肾功能衰竭患者，按随机数字表法将所有患者分为对照组和治疗组，每组各58例。对照组口服卡托普利片，25 mg/次，3次/d。治疗组在此基础上口服金水宝片，5片/次，3次/d。两组疗程8周。观察两组临床疗效，比较两组治疗前后主要症状积分、肾功能指标[血肌酐（Scr）、24 h尿蛋白定量（24 h UP）、尿素氮（BUN）、内生肌酐清除率（Ccr）]和血清血管紧张素Ⅱ（AngⅡ）、肿瘤坏死因子-α（TNF-α）、基质金属蛋白酶-9（MMP-9）、成纤维细胞生长因子23（FGF-23）水平的变化。结果 治疗后，治疗组总有效率是93.10%，显著高于对照组的79.31%（P＜0.05）。治疗后，两组主要症状（倦怠乏力、腰酸膝软、气短懒言、食少纳呆）积分均较治疗前显著降低（P＜0.05）；治疗后，治疗组主要症状积分低于对照组（P＜0.05）。治疗后，两组Scr、24 h UP、BUN均显著降低，而Ccr均显著增加（P＜0.05）；治疗后，治疗组肾功能指标改善更显著（P＜0.05）。治疗后，两组血清AngⅡ、TNF-α、MMP-9、FGF-23水平均显著下降（P＜0.05）；治疗后，治疗组AngⅡ、TNF-α、MMP-9、FGF-23水平低于对照组（P＜0.05）。结论 金水宝片联合卡托普利治疗慢性肾功能衰竭效果确切，能在较好的用药安全性基础上，有效减轻患者症状，纠正机体炎症和代谢紊乱状态，抑制肾小管纤维化，改善肾功能，值得临床推广应用。

Objective To analyze the clinical efficacy of Jinshuibao Tablets combined with captopril in treatment of chronic renal failure. Methods A total of 116 patients with chronic renal failure admitted to Nantong Hospital of Traditional Chinese Medicine from December 2020 to August 2023 were selected and divided into control group and treatment group according to random number table method, with 58 patients in each group. Patients in the control group werepo administered with Captopril Tablets, 25 mg/time, 3 times daily. Patients in the treatment group were po administered with Jinshuibao Tablets on the basis of the control group, 5 tablets/time, 3 times daily. Both groups were treated for 8 weeks. The clinical efficacy of the two groups was observed. The main symptom score, renal function index (Scr), 24 h urinary protein quantity (24 h UP), urea nitrogen (BUN), endogenous creatinine clearance (Ccr)] and serum levels of angiotensin Ⅱ (AngⅡ), tumor necrosis factor-α (TNF-α), matrix metalloproteinase-9 (MMP-9) and fibroblast growth factor 23 (FGF-23) were compared between the two groups before and after treatment. Results After treatment, the total effective rate of the treatment group was 93.10%, which was significantly higher than that of the control group (79.31%, P < 0.05). After treatment, the scores of the main symptoms (fatigue and weakness, lumbago and knee weakness, shortness of breath and lazy speech, eating less and being lazy) were significantly decreased in both groups compared with before treatment (P < 0.05). After treatment, the main symptom score of the treatment group was lower than that of the control group (P < 0.05). After treatment, Scr, 24 h UP, and BUN were significantly decreased, but Ccr was significantly increased in both groups (P < 0.05). After treatment, renal function index improved more significantly in treatment group (P < 0.05). After treatment, serum levels of AngⅡ, TNF-α, MMP-9, and FGF-23 in 2 groups were significantly decreased (P < 0.05). After treatment, the levels of AngⅡ, TNF-α, MMP-9, and FGF-23 in the treatment group were lower than those in the control group (P < 0.05). Conclusion Jinshuibao Tablets combined with captopril has a definite effect in treatment of chronic renal failure, and can effectively reduce the symptoms of patients on the basis of good drug safety, correct the inflammatory and metabolic disorders of the body, inhibit renal tubule fibrosis, and improve renal function, which is worthy of clinical application.

R983

南通市基础研究和民生科技计划指导性项目（MSZ21016）