六味地黄丸联合黄芪三七口服液治疗早期高血压肾损害48例  

Effect of Liuwei Dihuang Wan Combined Huangqi Sanqi Oral Liquids in Treating 48 Patients with Earlystage Kidney Damage Aroused by Hypertension

作　　者：马美[1] 梅峰[1] 巴应贵[1] 陈碧琴[1] 

机构地区：[1]青海大学附属医院,西宁810000

出　　处：《中国实验方剂学杂志》2015年第7期199-202,共4页Chinese Journal of Experimental Traditional Medical Formulae

摘　　要：目的:探讨六味地黄丸联合黄芪三七口服液对高血压早期肾损害的保护作用及对炎症因子和凝血纤溶系统的影响。方法:95例患者采用随机按数字表法分为对照组47例和联合组48例。对照组口服马来酸依那普利片,10 mg/次,1次/d;氨氯地平阿托伐他汀钙片,10 mg/次,1次/d,口服。联合组在对照组治疗的基础上加用六味地黄丸,6 g/次,3次/d,和黄芪三七口服液,10 m L/次,2次/d,口服。两组疗程均为12周。检测治疗前后24 h尿微量白蛋白(m Alb),尿微量白蛋白与肌酐的比值(ACR),胱抑素(Cys C),β2微球蛋白(β2-MG),尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG),白细胞介素-6(IL-6),肿瘤坏死因子-α(TNF-α),血浆D-二聚体(D-D)和血浆纤维蛋白原检测(FIB),尿素氮(BUN)和肌酐(Cr);进行治疗前后肝肾阴虚兼血瘀证评分。结果:经Ridit分析,联合组血压控制情况及中医证候疗效均优于对照组(P<0.05);治疗后联合组m Alb和ACR水平低于对照组(P<0.01),两组BUN和Cr治疗前后变化不明显,均在正常范围内;治疗后联合组Cys C,β2-MG和NAG水平均低于对照组(P<0.01);治疗后联合组D-D,FIB,IL-6和TNF-α水平均低于对照组(P<0.01)。结论:采用六味地黄丸和黄芪三七口服液与西药常规疗法的联合方案对高血压早期肾损害的保护优于单纯西药治疗,其作用机制可能与减轻炎症反应,调节凝血纤溶系统有关。Objective： To discuss the protective effect of the combination of traditional Chinese and Western medicine in treating early-stage kidney damage aroused by hypertension, and to investigate its influence on inflammation and coagulation-fibrinolysis system. Method： Ninety-five patients were randomly divided into the control group （47 cases） and the combination group with traditional Chinese and Western medicine treatment （48 cases） by a random number table. Patients in the control group received 10 mg enalapril tablets and 10 mg amlodipine once daily. Based on the treatment of the control group, patients in the combination r group added 6 g Liuwei Dihuang Wan thrice daily and 10 mL Huangqi Sanqi oral liquids twice daily. All patients in two groups received 12 weeks of treatment. Before and after treatment, 24-h microalbuminuria （mAlb）, ratio of microalbuminuria and creatinine （ACR）, cystatin C （CysC）, β2-microglobulin （β2-MG）, urinary N-acetyl-β-D- glucosaminidase （NAG） , interleukin-6 （IL-6） , tumor necrosis factor-α （TNF-α） , plasmic D-dimer （D-D） , fibrinogen （FIB） , urea nitrogen （BUN） and creatinine （CR） were detected. Scores of liver-kidney yin deficiency combined with blood stasis were graded. Result： The blood-pressure control and the curative effect of Chinese medical symptom in the combination group were superior to those in the control group （P 〈 0.05 ）. After treatment, levels of mAlb and ACR in the combination group were lower than those in the control group （P 〈 0.01 ）. But the changes of levels of BUN and Cr were not obvious, and they were within normal limits. Levels of CysC, β2-MG, NAG, D-D, FIB, IL-6 and TNF-α were lower than those in the control group （P 〈 0.01 ）. Conclusion： The effect of Liuwei Dihuang wan and Huangqi Sanqi oral liquid combined routine Western medicine therapy is superior to using Western medicine treatment alone. Its mechanism of action may be related to reducing the inflammatory response and

关 键 词：高血压肾损害 六味地黄丸 黄芪三七口服液 炎症因子 凝血纤溶系统 

分 类 号：R287[医药卫生—中药学]