目的 探究益肾化湿颗粒联合非奈利酮片对IgA肾病患者的临床疗效。方法 纳入2022年1月—2025年1月郑州大学第二附属医院收治的80例IgA肾病患者，依据治疗方案的差异分为对照组和治疗组，每组各40例。对照组口服非奈利酮片，20 mg/次，1次/d。治疗组在对照组治疗方案上口服益肾化湿颗粒，10 g/次，3次/d。两组均治疗3个月。对比两组治疗效果、中医证候积分、肾功能指标[尿素氮（BUN）、肌酐（Scr）、24 h尿蛋白排泄量及尿白蛋白排泄率（UAER）]、微炎症状态[高敏C反应蛋白（hs-CRP）、白细胞介素-6（IL-6）、糖原合酶激酶-3β（GSK-3β）及脂氧素A4（LXA4）]。结果 治疗组总有效率是96.00%，显著高于对照组的82.50%（P＜0.05）。两组治疗后中医证候积分均较治疗前下降（P＜0.05）；治疗后，与对照组相比治疗组中医证候积分更低（P＜0.05）。治疗后，两组Scr、BUN、24 h尿蛋白及UAER均较治疗前下降，且治疗组Scr、BUN、24 h尿蛋白及UAER均低于对照组（P＜0.05）。两组患者治疗后IL-6、Hs-CRP及GSK-3β均较治疗前下降（P＜0.05），LXA4较治疗前升高（P＜0.05）；且治疗组IL-6、Hs-CRP及GSK-3β均低于对照组，LXA4高于对照组（P＜0.05）。结论 益肾化湿颗粒联合非奈利酮片的协同干预策略可显著提升IgA肾病患者的临床疗效，较好改善肾功能指标，有效纠正微炎症状态，调节炎症因子水平。

Objective To explore the effects of Yishen Huashi Granules combined with Fenereidone Tablets in treatment of IgA nephropathy. Methods A total of 80 patients with IgA nephropathy who were admitted to the Second Affiliated Hospital of Zhengzhou University from January 2022 to January 2025 were included. They were divided into control group and treatment group based on the differences in treatment plans, with 40 cases in each group. Patients in control group was given oral Finerenone Tablets, 20 mg each time, once a day. Patients in treatment group was given oral Yishen Huashi Granules, 10 g each time, three times a day. Both groups were treated for 3 months. The therapeutic effects, TCM syndrome scores, renal function indicators (BUN, Scr, 24 h urine protein, and UAER), and micro-inflammatory status (hs-CRP, IL-6, GSK-3β, and LXA4) of two groups were compared. Results The total effective rate of the treatment group was 96.00%, significantly higher than that of the control group (82.50%) (P < 0.05). After treatment, the TCM syndrome scores of both groups decreased compared to those before treatment (P < 0.05). After treatment, the TCM syndrome scores of the treatment group were lower than those of the control group (P < 0.05). After treatment, the Scr, BUN, 24 h urine protein, and UAER of both groups decreased compared to those before treatment, and the Scr, BUN, 24 h urine protein, and UAER of treatment group were lower than those of control group (P < 0.05). After treatment, the IL-6, Hs-CRP, and GSK-3β of both groups decreased compared to those before treatment (P < 0.05), while LXA4 increased compared to that before treatment (P < 0.05). The IL-6, Hs-CRP, and GSK-3β of treatment group were lower than those of control group, and LXA4 was higher than that of control group (P < 0.05). Conclusion The combined intervention strategy of Yishen Huashi Granules and Finerenone Tablets can significantly enhance the clinical efficacy of patients with IgA nephropathy, effectively improve renal function indicators, effectively correct the micro-inflammatory state, and regulate the levels of inflammatory factors.

R983

河南省医学科技攻关计划联合项目（LHG]20230336）