目的观察化疗对肾单位损伤的变化过程和中药的防治作用。方法采用抽签随机分组法将400例化疗前肾功正常的患者分为中药加化疗组(治疗组)和单纯化疗组(对照组),每组200例,两组均接受30d为一周期的化疗方案,用放免法测定患者化疗不同时期尿液β2-微球蛋白(β2-M)、白蛋白(Alb)和免疫球蛋白G(IgG),连续观察肾单位损伤的状况和转归。治疗组在化疗前1天口服中药保肾合剂,3次/d,1次150ml,连服15d。对照组按化疗方案需要行常规水化、碱化或氯化。结果两组尿液β2-M,Alb和IgG异常指标均在化疗第7天达高峰,后逐渐下降,21d后大部分患者可恢复正常。治疗组化疗第14、21天转阴率明显高于对照组(P<0.01)。结论化疗对肾单位的损伤有时间规律可循,处理得当大部分是可逆的。中医药对化疗所致的肾单位损伤有显著防治优势。 Objective To observe the change of nephron injury induced by chemotherapy and the prevention and cure of traditional Chinese medicine. Methods 400 randomly selected patients with normal renal function before chemotherapy were randomly divided into two groups: Chinese medicine plus chemotherapy group (treatment group) and chemotherapy alone group (control group), 200 cases in each group. Both groups received 30 days of chemotherapy The urinary β2-M, Alb and IgG were measured by radioimmunoassay at different periods of chemotherapy, and the status and outcome of nephron injury were continuously observed. One day before chemotherapy, the treatment group orally took the traditional Chinese medicine Baosheng Mixture 3 times a day, 150ml once, and served for 15 days. The control group according to chemotherapy regimens need routine hydration, alkalization or chlorination. Results The urinary β2-M, Alb and IgG abnormalities in both groups peaked on the 7th day after chemotherapy, and then gradually decreased. Most of the patients returned to normal after 21 days. The negative conversion rate of the 14th and 21st days after chemotherapy in the treatment group was significantly higher than that in the control group (P <0.01). Conclusion The damage of nephrons to chemotherapy has a time-dependent pattern, most of which are reversible when properly treated. Chinese medicine on chemotherapy-induced nephron injury have significant prevention and control advantages.