目的 探究金匱腎氣丸與阿魏酸哌嗪聯(lián)合治療脾腎陽(yáng)虛型慢性腎小球腎炎的臨床療效。方法 納入2022年8月—2024年8月就診于武漢市中醫(yī)醫(yī)院的脾腎陽(yáng)虛型慢性腎小球腎炎患者121例，隨機(jī)分為對(duì)照組（60例）和治療組（61例）。對(duì)照組口服阿魏酸哌嗪片，50 mg/次，3次/d；治療組在對(duì)照組治療基礎(chǔ)上口服金匱腎氣丸，5 g/次，2次/d。兩組患者均進(jìn)行為期12周治療。觀察兩組患者臨床療效，比較治療前后兩組患者臨床癥狀改善時(shí)間，腎功能指標(biāo)尿微量白蛋白（U-mAlb）、估算腎小球?yàn)V過(guò)率（eGFR）和血清胱抑素C（CysC）水平，血清細(xì)胞因子血清鐵蛋白（SF）、C-反應(yīng)蛋白（CRP）及超氧化物歧化酶（SOD）水平。結(jié)果 干預(yù)后，對(duì)照組和治療組總有效率分別為80.00%和95.08%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P＜0.05）。干預(yù)后，治療組顏面浮腫、疲倦乏力、頻繁夜尿、腰脊酸痛等癥狀改善時(shí)間明顯短于對(duì)照組（P＜0.05）。干預(yù)后，兩組患者U-mAlb與CysC均顯著降低，而eGFR水平同步升高（P＜0.05），且治療組的指標(biāo)改善程度明顯優(yōu)于對(duì)照組（P＜0.05）。治療后，兩組血清SF和CRP水平均出現(xiàn)明顯下降，同時(shí)SOD活性有所提升（P＜0.05），且治療組的指標(biāo)改善程度明顯優(yōu)于常規(guī)對(duì)照組（P＜0.05）。結(jié)論 金匱腎氣丸聯(lián)合阿魏酸哌嗪在脾腎陽(yáng)虛型慢性腎炎治療中呈現(xiàn)顯著協(xié)同效應(yīng)，不僅有效改善患者疲倦乏力、頻繁夜尿等臨床癥狀，同時(shí)實(shí)現(xiàn)腎功能指標(biāo)和血清標(biāo)志物的同步改善，為脾腎陽(yáng)虛型慢性腎小球腎炎的個(gè)體化治療提供了新策略。

Objective To evaluate the clinical efficacy of Jinkui Shenqi Pills combined with piperazine ferulate in treating chronic glomerulonephritis characterized by spleen-kidney yang deficiency. Methods Patients (121 cases) with chronic glomerulonephritis of spleen-kidney yang deficiency in Wuhan Traditional Chinese Medicine Hospital from August 2022 to August 2024 were randomly divided into control (60 cases) and treatment (61 cases) group. Patients in the control group were po administered with Piperazine Ferulate Tablets, 50 mg/time, three times daily. Patients in the treatment group were po administered with Jinkui Shenqi Pills on the basis of the control group, 5 g/time, twice daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical evaluations were evaluated, and the improvement time of clinical symptoms, the levels of renal function indicators U-mAlb, CysC and eGFR, and the levels of serum SF, CRP and SOD in two groups before and after treatment were compared. Results After treatment, the total effective rates in the control group and the treatment group were 80.00% and 95.08%, respectively, and the difference between the two groups was statistically significant (P < 0.05). After treatment, the improvement time of symptoms such as facial edema, fatigue, frequent nocturia and lumbar and spinal pain in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, U-mAlb and CysC were significantly reduced in two groups, while eGFR levels were increased simultaneously (P < 0.05), and the improvement of indicators in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, serum SF and CRP levels in two groups were significantly decreased, while SOD activity was increased (P < 0.05), and the improvement of indicators in the treatment group was significantly better than that in the routine control group (P < 0.05). Conclusion The combination of Jinkui Shenqi Pills and piperazine ferulate synergistically enhances therapeutic efficacy in chronic glomerulonephritis patients with spleen-kidney yang deficiency. It not only effectively improves clinical symptoms such as fatigue and frequent nocturia in patients, but also achieves synchronous improvement of renal function indicators and serum markers, providing a new strategy for individualized treatment of chronic glomerulonephritis with spleen kidney yang deficiency.

R983

湖北省中醫(yī)藥管理局中醫(yī)藥科研項(xiàng)目（ZY2023F055）