目的 分析金水寶片聯(lián)合卡托普利治療慢性腎功能衰竭的臨床療效。方法 選取2020年12月—2023年8月南通市中醫(yī)院收治的116例慢性腎功能衰竭患者，按隨機數(shù)字表法將所有患者分為對照組和治療組，每組各58例。對照組口服卡托普利片，25 mg/次，3次/d。治療組在此基礎(chǔ)上口服金水寶片，5片/次，3次/d。兩組療程8周。觀察兩組臨床療效，比較兩組治療前后主要癥狀積分、腎功能指標[血肌酐（Scr）、24 h尿蛋白定量（24 h UP）、尿素氮（BUN）、內(nèi)生肌酐清除率（Ccr）]和血清血管緊張素Ⅱ（AngⅡ）、腫瘤壞死因子-α（TNF-α）、基質(zhì)金屬蛋白酶-9（MMP-9）、成纖維細胞生長因子23（FGF-23）水平的變化。結(jié)果 治療后，治療組總有效率是93.10%，顯著高于對照組的79.31%（P＜0.05）。治療后，兩組主要癥狀（倦怠乏力、腰酸膝軟、氣短懶言、食少納呆）積分均較治療前顯著降低（P＜0.05）；治療后，治療組主要癥狀積分低于對照組（P＜0.05）。治療后，兩組Scr、24 h UP、BUN均顯著降低，而Ccr均顯著增加（P＜0.05）；治療后，治療組腎功能指標改善更顯著（P＜0.05）。治療后，兩組血清AngⅡ、TNF-α、MMP-9、FGF-23水平均顯著下降（P＜0.05）；治療后，治療組AngⅡ、TNF-α、MMP-9、FGF-23水平低于對照組（P＜0.05）。結(jié)論 金水寶片聯(lián)合卡托普利治療慢性腎功能衰竭效果確切，能在較好的用藥安全性基礎(chǔ)上，有效減輕患者癥狀，糾正機體炎癥和代謝紊亂狀態(tài)，抑制腎小管纖維化，改善腎功能，值得臨床推廣應(yīng)用。

Objective To analyze the clinical efficacy of Jinshuibao Tablets combined with captopril in treatment of chronic renal failure. Methods A total of 116 patients with chronic renal failure admitted to Nantong Hospital of Traditional Chinese Medicine from December 2020 to August 2023 were selected and divided into control group and treatment group according to random number table method, with 58 patients in each group. Patients in the control group werepo administered with Captopril Tablets, 25 mg/time, 3 times daily. Patients in the treatment group were po administered with Jinshuibao Tablets on the basis of the control group, 5 tablets/time, 3 times daily. Both groups were treated for 8 weeks. The clinical efficacy of the two groups was observed. The main symptom score, renal function index (Scr), 24 h urinary protein quantity (24 h UP), urea nitrogen (BUN), endogenous creatinine clearance (Ccr)] and serum levels of angiotensin Ⅱ (AngⅡ), tumor necrosis factor-α (TNF-α), matrix metalloproteinase-9 (MMP-9) and fibroblast growth factor 23 (FGF-23) were compared between the two groups before and after treatment. Results After treatment, the total effective rate of the treatment group was 93.10%, which was significantly higher than that of the control group (79.31%, P < 0.05). After treatment, the scores of the main symptoms (fatigue and weakness, lumbago and knee weakness, shortness of breath and lazy speech, eating less and being lazy) were significantly decreased in both groups compared with before treatment (P < 0.05). After treatment, the main symptom score of the treatment group was lower than that of the control group (P < 0.05). After treatment, Scr, 24 h UP, and BUN were significantly decreased, but Ccr was significantly increased in both groups (P < 0.05). After treatment, renal function index improved more significantly in treatment group (P < 0.05). After treatment, serum levels of AngⅡ, TNF-α, MMP-9, and FGF-23 in 2 groups were significantly decreased (P < 0.05). After treatment, the levels of AngⅡ, TNF-α, MMP-9, and FGF-23 in the treatment group were lower than those in the control group (P < 0.05). Conclusion Jinshuibao Tablets combined with captopril has a definite effect in treatment of chronic renal failure, and can effectively reduce the symptoms of patients on the basis of good drug safety, correct the inflammatory and metabolic disorders of the body, inhibit renal tubule fibrosis, and improve renal function, which is worthy of clinical application.

R983

南通市基礎(chǔ)研究和民生科技計劃指導(dǎo)性項目（MSZ21016）