杨小波 利益 郭碧林

摘要 目的：探究腎炎方联合缬沙坦分散片治疗慢性肾小球肾炎患者的疗效及对肾功能的影响。方法：选取2016年2月至2019年2月重庆医科大学附属一医院合川医院肾脏内科收治的慢性肾小球肾炎患者122例作为研究对象，随机分为对照组和观察组，每组61例。对照组患者采用下缬沙坦分散片治疗，观察组在对照组基础上采用自拟肾炎方与缬沙坦分散片联合治疗，分析比较2组患者的肾功能指标的动态变化、炎性因子的表达水平、临床疗效及治疗后不良反应。结果：治疗后观察组TC、TG、BUN、Scr及24 hUPE5项指标的动态变化均低于对照组，差异有统计学意义（P<0.05），且观察组ALB动态变化高于对照组，差异有统计学意义（P<0.05）;治疗后观察组IL-6、IL-10、CRP及TNF-α水平明显低于对照组，差异有统计学意义（P<0.05），观察组治疗有效率（98.4%）优于对照组（86.9%），差异有统计学意义（P<0.05）;观察组不良反应发生率（6.6%）低于对照组（31.1%），差异有统计学意义（P<0.05）。结论：采用自拟肾炎方与缬沙坦分散片联合的治疗方案可增强疗效，提升肾功能，降低促炎性因子的表达水平及不良反应，值得在临床中推广普及。

关键词  肾炎方;缬沙坦分散片;慢性肾小球肾炎;肾功能;炎性因子指标;疗效;不良反应

Effects of Shenyan Formula Combined with Valsartan Dispersible Tablets on the Curative Effects and Renal Function of Patients with Chronic Glomerulonephritis

YANG Xiaobo，LI Yi，GUO Bilin

（Department of Nephrology，Hechuan Hospital，First Affiliated Hospital of Chongqing Medical University，Chongqing 401520，China）

Abstract Objective：To investigate the effects of Shenyan Formula combined with valsartan dispersible tablets on the efficacy and renal function in patients with chronic glomerulonephritis.Methods：A total of 122 patients with chronic glomerulonephritis admitted to Department of Nephrology，Hechuan Hospital，First Affiliated Hospital of Chongqing Medical University from February 2016 to February 2019 were enrolled as the study objects and were divided into 2 groups according to different treatment methods：a control group and a study group，with 61 cases in each group.The control group was treated with valsartan dispersible tablets.The study group based on the control group，were treated with combined with the treatment of Shenyan Formula and valsartan dispersible tablets to analyze the dynamic changes of renal function indicators in the 2 groups，the expression level of inflammatory factors，clinical efficacy and adverse reactions after treatment.Results：The dynamic changes of the 5 indexes of TC，TG，BUN，Scr and 24 h UPE in the study group were lower than those in the control group （P<0.05）.The dynamic changes of ALB in the study group were higher than those in the control group （P<0.05）.The levels of IL-6，IL-10，CRP and TNF-α in the study group were significantly lower than those in the control group （P<0.05）.The therapeutic efficacy of the study group was 98.4% higher than that of the control group （86.9%） （P>0.05）.The incidence of adverse reactions was 6.6% lower than that of the control group （31.1%） （]P<0.05）.Conclusion：The combination of self-made Shenyan Formula combines with valsartan dispersible tablets can enhance the curative effects，improve renal function，reduce the expression level and adverse reactions of pro-inflammatory factors，and it is worthy of popularization in the clinic.

Keywords Shenyan Formula; Valsartan dispersible tablets; Chronic glomerulonephritis; Renal function; Inflammatory factor index; Curative effect; Adverse reaction

中图分类号：R692.3+1 文献标识码：A doi：10.3969/j.issn.1673-7202.2020.08.016

近几年从临床接诊量来看，患有慢性肾小球肾炎的例数逐年上升，常见的病症为肾脏疾病，因此慢性肾小球肾炎又被称之为慢性肾炎，其诱发因素多且复杂，主要的临床表现为蛋白尿、血尿等，给予患者行之有效的临床药物治疗是极其必要的[1]。缬沙坦为血管紧张素Ⅱ受体阻滞剂的一种，为临床常用药物之一，主要通过阻闭机体血管紧张素受体等，降低肾小球囊内“三高（高灌注、高压力、高滤过）”以减缓肾小球病变硬化速度，降低机体中蛋白尿的含量，以此控制病情的进展。临床中缬沙坦虽治疗慢性肾炎的效果良好，但受多种因素的限制，导致单一用药的疗效欠佳。本次研究主要探究肾炎方联合缬沙坦分散片对慢性肾小球肾炎患者疗效及对肾功能的影响，现报道如下。……