目的 探討復(fù)方石韋顆粒聯(lián)合纈沙坦和前列地爾治療慢性腎小球腎炎的臨床療效。方法 選取2015年6月-2016年4月在陜西省友誼醫(yī)院腎病科接受治療的慢性腎小球腎炎患者60例，根據(jù)治療方法的差別分為對(duì)照組和治療組，每組各30例。對(duì)照組靜脈滴注前列地爾注射液，10 μg加入生理鹽水250 mL，1次/d；同時(shí)口服纈沙坦膠囊，1粒/次，1次/d。治療組在對(duì)照組的基礎(chǔ)上口服復(fù)方石韋顆粒，1袋/次，3次/d。兩組患者均連續(xù)治療4周。觀察兩組患者的臨床療效，同時(shí)比較治療前后兩組患者的血肌酐（Scr）、尿素氮（BUN）、24 h尿蛋白（24 h Upro）、尿紅細(xì)胞（RBC）、β2微球蛋白（β2-MG）、組織纖溶酶原激活物（t-PA）、纖溶酶原激活物抑制物-1（PAI-1）、基質(zhì)金屬蛋白酶-9（MMP-9）和血管內(nèi)皮生長因子（VEGF）水平的變化情況。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為80.00%、96.67%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的Scr、BUN、24 h Upro、RBC和β2-MG均明顯下降，與治療前比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療組的Scr、BUN、24 h Upro、RBC和β2-MG的降低程度明顯優(yōu)于對(duì)照組（P<0.05）。治療后，兩組的PAI-1、MMP-9和VEGF水平均明顯降低，t-PA明顯升高，與治療前比較差異有統(tǒng)計(jì)學(xué)意義（P<0.01）；治療組PAI-1、MMP-9、VEGF和t-PA的改善程度均優(yōu)于對(duì)照組（P<0.05）。結(jié)論 復(fù)方石韋顆粒聯(lián)合纈沙坦和前列地爾治療慢性腎小球腎炎臨床療效顯著，可明顯改善患者腎功能和臨床癥狀，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To observe the clinical curative effect of Compound Shiwei Granules combined with valsartan and alprostadil in treatment of chronic glomerulonephritis. Methods Patients (60 cases) with chronic glomerulonephritis in Department of Nephropathy of Shaanxi Friendship Hospital from June 2015 to April 2016 were divided into control and treatment groups according to different treatments, and each group had 30 cases. The patients in the control group were iv administered with Alprostadil Injection, 10 μg added into normal saline 250 mL, once daily, and were po administered with Valsartan Capsules, 1 grain/time, once daily. The patients in the treatment group were po administered with Compound Shiwei Granules on the basis of the control group, 1 bag/time, three times daily. The patients in two groups were treated for 4 weeks. After treatment, the efficacy was evaluated, and the changes of Scr, BUN, 24 h Upro, RBC, β2-MG, t-PA, PAI-1, MMP-9, and VEGF in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 80.00% and 96.67%, respectively, and there were differences between two groups (P<0.05). After treatment, Scr, BUN, 24 h Upro, RBC, and β2-MG in two groups were obviously decreased, and the difference was statistically significant (P<0.05). And the reducing degrees in treatment group were better than those in the control group, with significant difference between two groups (P<0.05). After treatment, PAI-1, MMP-9, and VEGF in two groups were significantly decreased, t-PA was obviously increased, and the difference was statistically significant (P<0.05). And PAI-1, MMP-9, VEGF, and t-PA in the treatment group improved better than those in the control group, with significant differences between two groups (P<0.05). Conclusion Compound Shiwei Granules combined with valsartan and alprostadil has a good clinical curative effect in treatment of chronic glomerulonephritis, can significantly improve the renal function and clinical symptoms, which has a certain clinical application value.