苓桂术甘汤加味治疗Ⅱ型心肾综合征的临床研究  

A clinical study of Linggui Zhugan decoction for treatment of type Ⅱ cardiorenal syndrome

作　　者：朱海云[1,2] 丁强[1] 褚玉茹 

机构地区：[1]天津市中医药研究院附属医院,天津300120 [2]天津中医药大学,天津300193

出　　处：《中国中西医结合急救杂志》2015年第4期412-414,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

摘　　要：目的探讨苓桂术甘汤加味对Ⅱ型心肾综合征（CRS）患者的疗效。方法选择天津市中医药研究院附属医院收治的30例CRS患者，用随机数字表法，按双盲法分为观察组和对照组，每组15例。两组患者均给予西医常规治疗，观察组在常规治疗基础上加用苓桂术甘汤加味（茯苓30g，肉桂10g，白术15g，炙甘草10g，巴戟天15g，大腹皮30g，黄芪30g，干姜10g，葶苈子15g），每H1剂，连用30d。观察两组患者治疗前后B型脑钠肽（BNP）、血肌酐（SCr）、尿素氮（BUN）、尿量的变化，以及临床疗效和中医证候积分疗效。结果两组治疗后BNP、SCr、BUN均较治疗前明显下降，尿量明显增多，且观察组的变化优于对照组[BNP（ng／L）：297．3±75．1比344．2±563，SCr（μmol／L）：139．7±62．1比154．4±39．7，BUN（mmol／L）：10．1±6．4比13．2±8．7，尿量（mud）：847．2±32．7比786．4±13．6，均P〈0．05]。观察组总有效率和中医证候积分总有效率均明显高于对照组[均为86．7％（13／15）比66．7％（10／15），均P〈0．05]。结论苓桂术甘汤加味可缓解心肾阳虚、水气凌心型患者的心衰症状，亦能减轻其合并的肾功能损伤；中西医结合治疗CRS疗效优于西药常规治疗对照组。Objective To approach the therapeutic effect of modified Linggui Zhugan decoction for treatment of patients with type Ⅱ cardiorenal syndrome （CRS）. Methods Thirty patients with CRS admitted to Affiliated Hospital of Tianjin Institute of Chinese Medicine were selected. By a random number table and double-blind method, they were divided into two groups： treatment and control groups, 15 cases in each group. The patients in both groups were treated with conventional western medicine, and those in the treatment group were additionally given traditional Chinese medicine （TCM） modified Linggui Zhugan decoction （including the following ingredients： Poria 30 g, Cinnamomi Cortex 10 g, Atractylodis Macrocephalae Rhizoma 15 g, Glycyrrhizae Radix et Rhizoma Preparata cum Melle 10 g, Morindae Officinalis Radix 15 g, Arecae Pericarpium 30 g, Astragali Radix 30 g, Zingiberis Rhizoma 10 g, Descurainiae Semen 15 g）, one dose daily for consecutive 30 days. Before and after treatment the changes in levels of B-type natriuretic peptide （BNP）, serum creatinine （SCr）, blood urea nitrogen （BUN）, amount of urine, clinical efficacy and TCM syndrome score efficacy were observed in two groups. Results After treatment, the levels of BNP, SCr, and BUN were significantly decreased, while urine volume was obviously increased compared with those before treatment in the two groups, and the degrees of changes in the treatment group were superior to those in control group [BNP （ng/L）： 297.3 ± 75.1 vs. 344.2 ± 56.3, SCr （μmol/L）： 139.7 ± 62.1 vs. 154.4 ± 39.7, BUN （mmol/L）： 10.1 ± 6.4 vs. 13.2 ± 8.7, urine volume （mL/d）： 847.2 ± 32.7 vs. 786.4 ± 13.6, all P 〈 0.05]. The total effective rates of patients and TCM syndrome scores in treatment group were significantly higher than those in control group [both 86.7% （13/15） vs. 66.7% （10/15）, both P 〈 0.05]. Conclusions Modified Linggui Zhugan decoction can alleviate the symptoms of yang deficiency of heart and kidney and heart fai

关 键 词：苓桂术甘汤加味 心肾阳虚 心肾综合征 中西医结合疗法 

分 类 号：R289.5[医药卫生—方剂学]