目的：观察雷公藤多苷联合缬沙坦治疗特发性膜性肾病（IMN）的疗效及安全性。方法：85 例IMN患者，按随机数字表法

分为观察组（42 例）和对照组（43 例），两组患者均给予降脂、抗血小板聚集、限制蛋白饮食等常规治疗。对照组患者在常规治疗基

础上加用缬沙坦80 mg，qd，若未出现明显不良反应，剂量增加至160 mg，qd；观察组患者在对照组基础上加用雷公藤多苷片40

mg，tid，症状完全缓解后减至20 mg，tid。两组患者均治疗12 个月。结果：观察组患者总有效率为92.86％，显著高于对照组的

74.42％，差异有统计学意义（P＜0.05）；治疗后，两组患者24 h 尿蛋白定量、总胆固醇（TC）、甘油三酯（TG）水平较治疗前下降，观

察组患者血清白蛋白（ALB）水平较治疗前升高，且24 h 尿蛋白定量和TG水平低于对照组，血清ALB水平高于对照组，差异均有

统计学意义（P＜0.05 或P＜0.01）。两组患者均未见明显不良反应发生。结论：雷公藤多苷联合缬沙坦可有效改善IMN患者的肾

功能和血脂水平，且具有较高的安全性。

OBJECTIVE：To observe therapeutic efficacy and safety of tripterygium glycosides combined with valsartan in the

treatment of idiopathic membranous nephropathy（IMN）. METHODS：A total of 85 patients with IMN were enrolled and randomly

divided into observation group（42 cases）and control group（43 cases）. Based on routine treatment（reducing lipid，anti-platelet aggregation，

protein dietary restriction），control group was additionally given oral valsartan，with initial dose of 80 mg/d，and gradually

adding the amount to 160 mg/d if there was no obvious ADR；based on control group，observation group was additionally given

Tripterygium glycosides tablet 40 mg，tid，and reducing the amount to 20 mg，tid after complete remission. 2 groups were treated

for 12 months. RESULTS：Total effective rate of observation group was 92.86％，which was significantly higher than that of control

group（74.42％），with statistical significance（P＜0.05）. Compared with before treatment，the levels of 24 h urine protein，TC

and TG of 2 groups were decreased after treatment，and serum albumin（ALB）of observation group increased；24 h urine protein

and TG of observation group was lower than control group，while the serum level of ALB was higher than control group，with statistical

significance（P＜0.05 or P＜0.01）. No obvious ADR was found in 2 groups. CONCLUSIONS：Tripterygium glycosides combined

with valsartan can improve the kidney function and blood lipid level of IMN patients with high safety.