自拟降压汤联合氯沙坦治疗肾血管性高血压的临床疗效及安全性  

The clinical efficacy and safety of self-made antihypertensive decoction combined with losartan to treat renovascular hypertension

作　　者：夏楠[1] 赵卫[1] 邵春林[1] 王慧颖[1] 胡婉英[1] 

机构地区：[1]上海曙光医院心内科,200021

出　　处：《疑难病杂志》2016年第8期782-786,共5页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的分析自拟降压汤联合氯沙坦治疗肾血管性高血压的临床疗效及安全性。方法选取2013年9月—2015年12月上海曙光医院心内科收治的肾血管性高血压患者48例作为研究对象,将其按照入院顺序随机分为观察组和对照组,每组24例,2组患者均给予氯沙坦进行治疗,观察组则在此基础上加用自拟降压汤进行中西药联合治疗。连续治疗8周后,评价2组疗效及血压、肾动脉血运、血管紧张素Ⅱ（AngⅡ）、血肌酐（SCr）、尿素氮（BUN）水平,并进行比较分析。结果观察组的总有效率为95.8%（23/24）,明显高于对照组的87.5%（21/24）,2组比较差异具有统计学意义（χ^2=1.092,P〈0.05）。治疗后,2组患者的收缩压、舒张压均明显低于治疗前（P〈0.05）,且观察组明显低于对照组（t=2.319、2.804,P〈0.05）。与治疗前比较,观察组治疗后肾动脉EDV和PSV明显增高（P〈0.01）,肾IR显著降低（P〈0.01）;对照组治疗后EDV、PSV、IR与治疗前比较差异无统计学意义（P〈0.01）;观察组治疗后EDV、PSV、IR改善均优于对照组（P〈0.01）。治疗后,2组患者的血浆AngⅡ水平均明显低于治疗前（t=7.177、3.711,P〈0.05）,且观察组明显低于对照组（t=3.873,P〈0.05）;治疗后,2组患者血肌酐水平均低于治疗前,但差异无统计学意义（t=0.305、0.304,P〉0.05）,血尿素氮水平均低于治疗前,差异有统计学意义（t=7.426、8.699,P〈0.01）,观察组患者SCr、BUN水平虽低于对照组,但差异均无统计学意义（t=0.147、1.025,P〉0.05）。结论自拟降压汤联合氯沙坦治疗可有效降低肾血管性高血压患者的Ⅱ压及AngⅡ和SCr水平,改善肾动脉血运,且安全性好。Objective To analyze the clinical efficacy and safety of self-made antihypertensive decoction combined with losartan to treat renovascular hypertension.Methods 48 cases of patients with renovascular hypertension during the peri-od of September 2013 to December 2015 in Department of Cardiology, Shanghai Shuguang Hospital were enrolled into this study.According to the order of hospitalization,patients were randomly divided into control group （24 cases） and experimental group （24 cases） .Patients in control group were treated with losartan, while patients in experimental group were treated with losartan combined with self-made Antihypertensive Decoction.After 8 weeks, the level of blood pressure, angiotensinⅡ, ser-um creatinine were evaluated and analyzed for all patients in two groups.Results The total effective rate of the experimental group （95.8%,23/24） was higher than that of the control group （87.5%,21/24）, there were statistically significant differ-ences （χ^2 =1.092, P 〈0.05）.After treatment, the two groups of patients with systolic blood pressure, diastolic blood pres-sure were significantly lower after treatment than that before （ P 〈0.05）, and the observation group was significantly lower than that of the control group （ t =2.319, t =1.804, P 〈0.05）;compared with before treatment, after treatment in obser-vation group renal artery EDV and PSV increased significantly （ P 〈0.01）, renal IR significantly reduced （ P 〈0.01）;af-ter the control treatment group, EDV, PSV, before treatment and IR difference no statistical significance （ P 〈0.01）;after treatment in observation group EDV, PSV, IR improve were better than that of the control group （ P 〈0.01）.After treat-ment, the plasma Ang II levels in two groups of patients were significantly lower than the treatment before （ t =7.177, t =3.711, P 〈0.05） and the observation group was significantly lower than that of the control group （ t =3.873, P 〈0.05）;after treatment, 2 groups of patients w

关 键 词：自拟降压汤 肾血管性高血压 血管紧张素Ⅱ 疗效 安全性 

分 类 号：R544.1[医药卫生—心血管疾病]