目的 探究雷公藤多苷片聯(lián)合氯沙坦鉀治療特發(fā)性膜性腎病的臨床療效。方法 選取2017年12月—2019年12月在保定市第二中心醫(yī)院接受治療的80例特發(fā)性膜性腎病患者，隨機(jī)分為對照組（40例）和治療組（40例）。對照組口服氯沙坦鉀片，50mg/次，1次/d。治療組在對照組的基礎(chǔ)上口服雷公藤多苷片，20mg/次，3次/d。兩組患者均治療12個月。觀察兩組患者臨床療效，比較治療前后兩組患者外周血Th17/Treg、miR-155水平及24h尿蛋白和血清白蛋白水平。結(jié)果 治療后，與對照組總有效率（52.50%）比較，治療組明顯升高（77.50%，P<0.05）。與治療前比較，治療后兩組Th17/Treg、miR-155水平均明顯降低（P<0.05），且與對照組比較，治療組明顯降低（P<0.05）。治療后，兩組24h尿蛋白水平均明顯降低，而血清白蛋白水平均升高（P<0.05），且與對照組比較，治療組24h尿蛋白、血清白蛋白水平明顯好于對照組（P<0.05）。結(jié)論 雷公藤多苷片聯(lián)合氯沙坦鉀治療特發(fā)性膜性腎病可能通過降低患者外周血Th17/Treg、miR-155水平發(fā)揮控制病情的作用，療效顯著。

Objective To explore the effect of Tripterysium Glycosides Tablets combined with losartan potassium in treatment of idiopathic membranous nephropathy. Methods Patients (80 cases) with idiopathic membranous nephropathy in Baoding Second Central Hospital from December 2017 to December 2019 were randomly divided into control (40 cases) and treatment (40 cases) group. Patients in the control group were po administered with Losartan Potassium Tablets, 50 mg/time, once daily. Patients in the treatment group were po administered with Tripterysium Glycosides Tablets on the basis of the control group, 20 mg/time, three times daily. Patients in two groups were treated for 12 months. After treatment, the clinical evaluation was evaluated, the Th17/Treg and miR-155 levels in peripheral blood, and the 24 h urinary protein and serum albumin levels in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group (77.50%) was significantly higher than that of the control group (52.50%, P < 0.05). Compared with those before treatment, the levels of Th17/Treg and miR-155 in two groups were significantly decreased after treatment, and which in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the level of 24 h urinary protein in two groups was significantly decreased, while the level of serum albumin was significantly increased in two groups (P< 0.05). Compared with the control group, the levels of 24 h urinary protein and serum albumin in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Tripterysium Glycosides Tablets combined with losartan potassium in treatment of idiopathic membranous nephropathy disease by reducing the levels of Th17/Treg and miR-155 in peripheral blood, with significant effect.

R983

保定市科技計劃項目（18ZF109）