【目的】探讨益肾固精抗炎方（由白茅根、党参、山茱萸、牡丹皮、枸杞子、菟丝子、淮山药、炙黄芪、茯苓、熟地黄 等组成）在气阴两虚型狼疮性肾炎（lupus nephritis，LN）治疗中的应用价值。【方法】将116例气阴两虚型LN患者随机分为观察 组和对照组，每组各58例。对照组给予西医常规治疗，观察组在对照组的基础上联合益肾固精抗炎方治疗，疗程为6个 月。观察2组患者治疗前后中医证候积分、肾功能指标、免疫功能指标、血清白细胞介素18（IL-18）、同型半胱氨酸（Hcy）、 转化生长因子β1（TGF-β1）、胱抑素C（Cys C）水平的变化情况，比较2组患者治疗后的临床疗效及抗双链DNA（ds-DNA）抗 体转阴情况。【结果】（1）疗效方面，治疗6个月后，观察组的总有效率为94.83%（55/58），对照组为75.86%（44/58），组间比 较，观察组的疗效明显优于对照组（χ2 = 5.453，P＜0.05）。（2）中医证候积分方面，治疗后，2组患者的主症积分（浮肿、乏 力）和次症积分（腰膝酸软、便溏）均较治疗前降低（P＜0.05），且观察组的降低作用均明显优于对照组（P＜0.01）。（3）肾功能 方面，治疗后，2组患者的血清尿素氮（BUN）、血清肌酐（Scr）、24 h尿蛋白定量均较治疗前降低（P＜0.05），且观察组的降 低作用均明显优于对照组（P＜0.01）。（4）炎性因子及纤维化指标方面，治疗后，2组患者的血清IL-18、TGF-β1、Hcy、Cys C 水平均较治疗前降低（P＜0.05），且观察组的降低作用均明显优于对照组（P＜0.01）。（5）免疫功能方面，治疗后，2组的T细 胞亚群CD4+、CD4+/CD8+及补体C3水平均较治疗前升高（P＜0.05），且观察组的升高作用均明显优于对照组，差异均有统计 学意义（P＜0.05或P＜0.01）。（6）抗ds-DNA抗体转阴方面，观察组的抗ds-DNA抗体转阴率为77.59%（45/58），明显高于对照 组的55.17%（32/58），组间比较，差异有统计学意义（P＜0.05）。【结论】对于气阴两虚型LN患者而言，联合益肾固精抗炎方 治疗有助于减轻炎症反应，调节免疫功能，促进肾功能恢复，提高临床疗效。

Objective To investigate the clinical value of Yishen Gujing Kangyan Prescription（with the actions of benefiting the kidneys，consolidating essence and anti-inflammatory，mainly composed of Imperatae Rhizoma， Codonopsis Radix， Corni Fructus， Moutan Cortex， Lycii Fructus， Cuscutae Semen， Dioscoreae Rhizoma， honey-roasted Astragali Radix，Poria， Rehmanniae Radix Praeparata，etc.）in the treatment of lupus nephritis （LN）of qi and yin deficiency type. Methods A total of 116 patients with LN of qi and yin deficiency type were randomly divided into observation group and control group，58 cases in each group. The control group was given conventional western medicine treatment， and the observation group was treated with the combination of Yishen Gujing Kangyan Prescription on the basis of treatment for the control group. Both groups were treated for a period of 6 months. The changes of traditional Chinese medicine（TCM） syndrome scores， renal function parameters， immune function indicators，serum interleukin 18（IL-18），homocysteine（Hcy），transforming growth factor β1 （TGF-β1）， cystatin C（Cys C）levels in the two groups were observed before and after the treatment. After treatment，the clinical efficacy and the negative-conversion of anti-double-stranded DNA（ds-DNA）antibody were compared between the two groups. Results（1）After 6 months of treatment， the total effective rate of the observation group was 94.83%（55/58）， and that of the control group was 75.86%（44/58）. The intergroup comparison showed that the therapeutic effect of the observation group was significantly superior to that of the control group（χ2 = 5.453，P＜0.05）.（2）After treatment，the scores of primary symptoms（edema，fatigue）and secondary symptoms（lumbar and knee soreness， loose stools）in the two groups were lower than those before treatment（P＜0.05），and the effect on lowering the scores in the observation group was significantly superior to that in the control group（P＜0.01）.（3）After treatment， the levels of renal function parameters of blood urea nitrogen（BUN），serum creatinine（Scr），and 24 -hour urine protein quantification of the two groups were all lower than those before treatment （P＜0.05）， and the effect on lowering renal function parameters in the observation group was significantly superior to that in the control group（P＜0.01）.（4）After treatment，serum IL-18，TGF-β1，Hcy and Cys C levels of the two groups of patients were all reduced compared with those before treatment（P＜0.05），and the effect on lowering the levels of inflammatory factors and fibrosis parameters in the observation group was significantly superior to that in the control group（P＜0.01）.（5）After treatment，the levels of immune function indicators of T cell subsets CD4+ ， CD4+/CD8+ and complement C3 in the two groups were increased compared with those before treatment（P＜0.05）， and the increase in the observation group was significantly superior to that in the control group，and the differences were all statistically significant（P＜0.05 or P＜0.01）.（6）The negative-conversion rate of anti-ds-DNA antibody in the observation group was 77.59%（45/58）， which was significantly higher than that in the control group（55.17%，32/58），and the difference was statistically significant between the two groups（P＜0.05）. Conclusion For the treatment of patients with LN of qi and yin deficiency type，Yishen Gujing Kangyan Prescription exerts synergistic effect on reducing inflammatory response， regulating immune function，promoting the recovery of renal function，and enhancing clinical efficacy.

R593.24+2

海南省卫生健康委员会科研项目（编号：19A200152）