自拟杞菊地黄汤辅治高血压早期肾损害疗效观察  

Observation of curative effect of Qiju Dihuang decoction on early renal damage in patients with hypertension

作　　者：钱雷[1] 徐天舒[1] 

机构地区：[1]南京大学医学院附属鼓楼医院,江苏南京210008

出　　处：《现代中西医结合杂志》2016年第17期1855-1858,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察自拟杞菊地黄汤辅治高血压患者早期肾损害的临床疗效。方法将106例老年高血压早期肾损害患者随机分为观察组及对照组各53例,对照组给予常规西医治疗,观察组在常规西医治疗基础上给予自拟杞菊地黄汤治疗,2组均治疗12周。记录治疗前后收缩压(SBP)、舒张压(DBP)及平均动脉压(MAP)变化情况,检测2组治疗前后尿微量清蛋白(MA)及尿β2-微球蛋白(β2-MG)、血肌酐(Cr)及血尿素氮(BUN)水平及血清一氧化氮(NO)、内皮素-1(ET-1)水平;记录治疗前后肾动脉血流动力学数值。结果 2组治疗后SBP、DBP、MAP、MA及β2-MG明显低于治疗前,且观察组改善情况优于对照组;2组治疗前后BUN和Cr水平比较差异无统计学意义。2组治疗后血清NO水平均有所降低,ET-1水平升高,且观察组血清NO水平低于对照组,ET-1水平高于对照组,差异有统计学意义(P均<0.05);治疗后观察组肾动脉收缩期峰值流速(PSV)、舒张末期流速(EDV)均高于对照组,而肾功能阻力指数(RI)低于对照组,差异有统计学意义(P均<0.05)。结论自拟杞菊地黄汤能够显著调节高血压早期肾损害患者血压水平,扩张肾动脉血管,调节血管活性物质的产生及保护血管内皮细胞功能,较单纯的西医治疗具有一定肾保护功能。Objective It is to observe the clinical curative effect of Qiju Dihuang decoction on the early renal damage in patients with hypertension. Methods 106 elderly patients with hypertension and early renal damage were randomly divided into observation group and control group,each group had 53 cases. The control group was treated with normal western medicine,and the observation group was treated with Qiju Dihuang decoction on the basis of treatment in control group. Both groups were treated for 12 weeks. The changes of SBP,DBP and MAP before and after treatment were observed,the levels of urine MA,urine β2-MG,serum Cr and BUN and NO,ET-1 were determined before and after treatment in both groups. The indexes of haemodynamics of renal artery were detected before and after treatment. Results The levels of SBP,DBP,MAP,MA and β2-MG after treatment were significantly lower than that before treatment in both groups,and the improvements in observation group were more significant. There was no significant changes of BUN and Cr after treatment compared with that before treatment. The serum level of NO decreased while that of ET-1 increased after treatment in both groups,and the decrease or increase in observation group were better than that in control group,the differences were significant（ P〈0. 05）. After treatment the indexes of haemodynamics of renal artery PSV,EDV were higher while RI was lower in observation group than that in control group,the differences were significant（ P〈0. 05）. Conclusion Qiju Dihuang decoction can effectively improve blood pressure,extend renal artery,regulate the production of vasoactive substances and protect the？ vascular endothelial cells function in the patients with early renal damage and hypertension,it has some renal protecting effect compared with simple western medicine therapy.

关 键 词：杞菊地黄汤 高血压早期肾损害 中西医结合疗法 

分 类 号：R544.1[医药卫生—心血管疾病] R692[医药卫生—内科学]