罗寅亮 束永兵 郑昌志 储杨敏 周艳利 何泽云

摘要 目的：探究清熱降浊、益气活血中药方剂联合阿托伐他汀钙片治疗慢性肾小球肾炎（CGN）患者的临床疗效。方法：选取2017年5月至2018年5月六安市中医院收治的CGN患者90例作为研究对象，按照随机数字表法分为对照组和观察组，每组45例。对照组患者给予饮食指导，并口服阿托伐他汀钙片治疗。观察组在对照组治疗的基础上给予清热降浊、益气活血中药治疗。2组CGN患者均治疗50 d，观察并记录2组患者的疗效、血脂指标和肾功能指标。结果：与治疗前比较，2组CGN患者的总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDL）、血清尿素氮（BUN）、血肌酐（Scr）和24 h尿蛋白定量均明显降低，差异有统计学意义（均P<0.05），且观察组患者的TC、Scr、BUN和24 h尿蛋白定量水平比对照组降低更显著（均P<0.05）。观察组患者的总有效率为93.33%，对照组患者的总有效率为84.44%，差异有统计学意义（P<0.05）。结论：清热降浊、益气活血中药方剂联合阿托伐他汀钙片可以显著降低CGN患者的血清血脂水平，使之恢复正常，改善肾功能，具有较高的临床应用价值。

关键词 益气活血;清热降浊法;慢性;肾小球肾炎;临床疗效;肾功能;血脂;联合用药

Clinical Effect of Clearing Away Heat and Reducing Turbidity，Replenishing Qi and Activating Blood on Chronic Glomerulonephritis

LUO Yinliang1，SHU Yongbing1，ZHENG Changzhi1，CHU Yangmin1，ZHOU Yanli2，HE Zeyun3

（1 Department of Nephrology，Lu′an Hospital of Chinese Medicine，Liu′an 237100，China; 2 Department of Nephrology，the Affiliated TCM Hospital of Guangzhou Medical University，Guangzhou 510130，China; 3 Department of Nephrology，the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine，Changsha 410007，China）

Abstract Objective：To explore the clinical efficacy of traditional Chinese medicine prescriptions for clearing away heat and reducing turbidity，replenishing qi and activating blood combined with atorvastatin calcium tablets in the treatment of patients with chronic glomerulonephritis（CGN）.Methods：From May 2017 to May 2018，90 CGN patients who were treated in the Department of Nephrology，Lu′an City Hospital of Traditional Chinese Medicine were selected as the research objects.They were divided into an observation group and a control group by random number table method，with 45 cases in each group.Patients in the control group were given dietary guidance and treated with atorvastatin calcium tablets.On the basis of the treatment of the control group，the observation group was given Chinese medicines for clearing away heat and reducing turbidity，replenishing qi and promoting blood circulation.Both groups of CGN patients were treated for 50 days，and the curative effect，blood lipid indexes and renal function indexes of the 2 groups were observed and recorded.Results：Compared with before treatment，the TC，TG，LDL，Scr，BUN and 24 h urine protein quantification of the two groups of CGN patients were significantly reduced，the difference was statistically significant（P<0.05），and the quantitative levels of TC，Scr，BUN and 24 h urine protein of the observation group decreased more significantly than those in the control group（P<0.05）.The total effective rate of patients in the observation group was 93.33%，and the total effective rate of CGN patients in the control group was 84.44%，the difference was statistically significant（P<0.05）.Conclusion：Traditional Chinese medicine prescriptions for clearing away heat and reducing turbidity，replenishing qi and activating blood combined with atorvastatin calcium tablets can significantly reduce the serum lipid levels of CGN patients，restore them to normal，and improve renal function，which has high clinical application value.

Keywords Replenishing qi and activating blood; The Method of clearing heat and lowering turbidity; Chronic; Glomerulonephritis; Clinical curative effect; Renal function; Blood lipid; Combination medication

中图分类号：R242文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.17.019

慢性肾小球肾炎（Chronic Glomerulonephritis，CGN）属于免疫性疾病，主要是由于慢性肾小球病变所导致[1]。研究表明，目前我国CGN发病率为10%以上，患者发病时会出现蛋白尿、血尿、高血压以及水肿等症状，临床常合并高脂血症，是严重危害人类健康的常见疾病之一。该病可发生于任何年龄段，青中年患者较多，男性患者较常见。多数起病缓慢、隐匿，若患者不能得到及时有效的治疗，有很大可能会导致肾功能衰竭。CGN的治疗主要以改善临床症状、控制肾功能进行性恶化及防治并发症为主[2-3]。西医中常用降低血脂和肾脏保护作用的药物如阿托伐他汀进行治疗，但该药容易产生肝功能异常、高血糖等不良反应。……