罗伯珣 张卫平 王骏

[摘要] 目的 探讨海昆肾喜胶囊联合来氟米特治疗慢性肾小球肾炎（CGN）的效果及对内皮细胞功能及免疫功能的影响。 方法 选取2016年6月—2019年6月广东省惠州市中心人民医院及南方医科大学南方医院就诊的89例CGN患者，采用随机数字表法分为对照组44例和观察组45例。对照组给予来氟米特治疗，观察组给予海昆肾喜胶囊联合来氟米特治疗，两组均给予治疗3个月。评价并比较两组临床疗效，比较两组治疗前后血清血肌酐（Scr）、尿素氮（BUN）、一氧化氮（NO）、内皮素-1（ET-1）水平及外周血CD4+、CD8+、CD4+/CD8+水平。记录两组治疗过程中不良反应发生情况。 结果 治疗后，观察组临床总有效率高于对照组（P < 0.05）。两组血清Scr、BUN、ET-1水平均明显低于治疗前，且观察组低于对照组（P < 0.05），NO水平均明显高于治疗前，且观察组高于对照组（P < 0.05）。治疗后，两组外周血CD4+水平和CD4+/CD8+均明显高于治疗前，且观察组高于对照组（P < 0.05），CD8+水平均明显低于治疗前，且观察组低于对照组（P < 0.05）。治疗期间，两组不良反应发生率比较，差异无统计学意义（P > 0.05）。 结论 海昆肾喜胶囊联合来氟米特治療CGN的临床效果显著，有助于改善内皮细胞功能、提高机体免疫功能，且安全性较好。

[关键词] 慢性肾小球肾炎;海昆肾喜胶囊;来氟米特;内皮细胞功能;免疫功能

[中图分类号] R692.31          [文献标识码] A          [文章编号] 1673-7210（2020）08（b）-0107-04

[Abstract] Objective To investigate the effect of Haikunshenxi Capsules combined with Leflunomide on chronic glomerulonephritis （CGN） and its effect on endothelial cell function and immune function. Methods From June 2016 to June 2019， 89 CGN patients admitted in Huizhou Central People′s Hospital and Southern Hospital of Southern Medical University were selected. According to the method of random number table， the patients were randomly divided into control group （44 cases） and observation group （45 cases）. The control group was treated with Leflunomide， the observation group was treated with Haikunshenxi Capsules and Leflunomide， both groups were treated for 3 months. The clinical effect of the two groups was evaluated and compared， the levels of serum creatinine （Scr）， urea nitrogen （BUN）， nitric oxide （NO）， endothelin-1 （ET-1） and peripheral blood CD4+， CD8+， CD4+/CD8+ were compared before and after treatment， and the adverse reactions were recorded in the two groups. Results After treatment， the total clinical effective rate of the observation group was higher than the control group （P < 0.05）. The serum Scr， BUN and ET-1 levels of the two groups were significantly lower than those before treatment， and the observation group was lower than the control group （P < 0.05）， the NO level was significantly higher than that before treatment， and the observation group was higher than the control group （P < 0.05）. The level of CD4+ and CD4+/CD8+ in peripheral blood of the two groups after treatment were significantly higher than those before treatment， and the observation group was higher than the control group （P < 0.05）， the CD8+ level was significantly lower than that before treatment， and the observation group was lower than the control group （P < 0.05）. During the treatment， there was no significant difference in the incidence of adverse reactions between the two groups （P > 0.05）. Conclusion Haikunshenxi Capsules combined with Leflunomide has a significant clinical effect in the treatment of CGN， which is helpful to improve the function of endothelial cells， improve the immune function of the body， and has a good safety.

[Key words] Chronic glomerulonephritis; Haikunshenxi Capsules; Leflunomide; Endothelial cell function; Immune function

慢性肾小球肾炎（CGN）多表现为血尿、蛋白尿、水肿、高血压等，具有发病隐匿、进展缓慢、病程较长、病因复杂等特点，严重者会导致肾衰竭[1]。CGN在发病早期无明显的症状，患者到临床就诊时往往已经伴有不同程度肾功能不全，若治疗不及时会进展为慢性肾衰竭，危害患者的身体健康[2]。目前，临床治疗CGN多应用血管紧张素转化酶抑制剂、抑制肾脏纤维化、延缓肾衰竭等的药物，然而疗效并不理想[3-4]。来氟米特是一种异噁唑类化合物，属于新型的免疫抑制剂，能够抑制淋巴细胞和B细胞的增殖，在临床上用于自身免疫性肾脏疾病的治疗，如狼疮性肾炎等，也用于CGN的治疗，然而单独应用于CGN的疗效欠佳[5-6]。……