目的 探讨尿毒清颗粒联合乙酰半胱氨酸治疗慢性肾脏病的临床疗效。方法 选取2016年9月—2019年2月在南京医科大学第二附属医院诊治的120例慢性肾脏病患者作为研究对象，根据随机数字表法将患者均分为对照组和观察组，每组各60例。对照组静脉滴注乙酰半胱氨酸注射液，40 mL用5%葡萄糖注射液250 mL稀释，1次/d。观察组在对照组治疗的基础上给予尿毒清颗粒，1袋/次，用温开水冲服，3次/d。两组均治疗观察1个月。观察两组患者的临床疗效，同时比较两组治疗前后的降钙素原（PCT）、尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）、血清尿素氮（BUN）、血肌酐（Scr）水平，以及患者不良反应发生情况。结果 治疗后，观察组的总有效率为98.3%，显著高于对照组的88.3%，两组比较差异具有统计学意义（P<0.05）。两组治疗后的血清PCT、尿NAG水平都显著低于治疗前，同组治疗前后比较差异具有统计学意义（P<0.05）；且观察组治疗后血清PCT、尿NAG水平均显著低于对照组，两组比较差异具有统计学意义（P<0.05）。两组治疗后的血清BUN与Scr水平都显著低于治疗前，同组治疗前后比较差异具有统计学意义（P<0.05）；观察组BUN和Scr水平均显著低于对照组，两组比较差异具有统计学意义（P<0.05）。观察组治疗期间的头晕、头痛和干咳等不良反应发生率为3.3%，显著低于对照组的16.7%（P<0.05）。结论 尿毒清颗粒联合乙酰半胱氨酸治疗慢性肾脏病具有较好的临床疗效，能抑制PCT，降低尿NAG的水平，同时促进肾功能的恢复，减少不良反应的发生，具有一定的临床推广应用价值。

Objective To investigate the clinical effects of Niaoduqing Granules combined with acetylcysteine in treatment of chronic kidney disease. Methods Patients (120 cases) with chronic kidney disease in the Second Affiliated Hospital of Nanjing Medical University from September 2016 to February 2019 were divided into control and observation group accorded to the random number table method, and each group had 60 cases. Patients in the control group were iv administered with Acetylcysteine Injection, 40 mL was diluted with 5% glucose injection 250 mL, once daily. Patients in the observation group were po administered with Niaoduqing Granules on the basis of control group, 1 bag/time, and washed with warm water for 3 times daliy. Both groups were observed for 1 month. After treatment, the clinical efficacy in two groups was observed, and the levels of PCT, NAG, BUN, and Scr before and after treatment were compared, and the incidence of adverse reactions during the treatment were compared. Results After treatment, the total effective rate in the observation group was 98.3%, which was significantly higher than 88.3% in the control group, and the difference between two groups was statistically significant (P<0.05). After treatment, the levels of serum PCT and urinary NAG in two groups were significantly lower than those before treatment, the difference before and after treatment in the same group was statistically significant (P<0.05). After treatment, serum PCT and urine NAG levels in the observation group were significantly lower than those in the control group, and the differences between two groups were statistically significant (P<0.05). After treatment, the levels of serum BUN and Scr in two groups were significantly lower than those before treatment, the difference before and after treatment in the same group was statistically significant (P<0.05). After treatment, the levels of BUN and Scr in the observation group were significantly lower than those in the control group, and the difference between two groups was statistically significant (P<0.05). The incidence of adverse reactions such as dizziness, headache and dry cough was 3.3% in the observation group, which was significantly lower than 16.7% in the control group (P<0.05). Conclusion Niaoduqing Granules combined with acetylcysteine in treatment of chronic kidney disease has a good clinical effect, can inhibit PCT, reduce the level of urinary NAG, promote the recovery of renal function, and reduce the occurrence of adverse reactions, has a certain clinical promotion and application value.

R983

江苏省第五期“333工程”培养资助项目（BRA2018170）