下瘀血汤治疗高血压性肾损害夜尿增多临床观察  

Clinical observation of Xiayuxue decoction on nocturia increased hypertensive kidney damage

作　　者：张承承[1] 蔡倩[1] 佟欢欢[2] 王暴魁[1] 

机构地区：[1]北京中医药大学东方医院肾病科,北京100078 [2]北京中医药大学东方医院资产管理与招标办公室,北京100078

出　　处：《河北中医》2017年第11期1641-1645,共5页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察下瘀血汤治疗高血压性肾损害夜尿增多的临床疗效。方法将60例高血压性肾损害夜尿增多患者随机分为2组,对照组30例予西医常规治疗,治疗组30例在对照组治疗基础上加用下瘀血汤,2组均治疗14 d。治疗前后对所有患者进行血瘀证的中医证候评分,测定患者治疗前后肾早期损害指标[N-乙酰-β-D-葡萄糖苷酶(尿NAG酶)、尿微量白蛋白]、肾功能[血尿酸、血肌酐(Cr)、血尿素氮(BUN)、内生肌酐清除率(Ccr)]及24 h尿蛋白定量,记录患者治疗前后夜尿次数和夜尿量,并进行统计学分析。结果治疗组治疗后尿NAG酶、尿微量白蛋白、血尿酸、夜尿次数及夜尿量均较本组治疗前下降(P<0.05);对照组治疗后尿NAG酶、尿微量白蛋白均较本组治疗前下降(P<0.05);治疗后治疗组尿微量白蛋白及夜尿次数均低于对照组(P<0.05)。治疗组治疗后腰脊痠痛、腰部刺痛、夜尿次数积分及总积分均较本组治疗前降低(P<0.05),治疗后治疗组腰部刺痛积分及总积分低于对照组(P<0.05)。结论下瘀血汤对减少高血压性肾损害夜尿增多疗效肯定,具有减少夜尿次数、改善患者生活质量及降低血尿酸的作用,且无明显不良反应。Objective To observe the clinical effects of Xiayuxue decoction on the treatment of nocturia increased hypertensive kidney damage. Methods 60 patients with nocturia increased hypertensive kidney damage were randomly divided into two groups. 30 cases in the control group were treated by adjusting lifestyle and routine western medicine,and 30 cases in the treatment group were treated by Xiayuxue decoction on the basis of the control group. The treatment course was 14 d in two groups. All patients were scored the scores of blood stasis syndrome. The hypertensive kidney damge indexes including urine NAG enzyme and urine microalbumin,the renal function including blood uric acid,serum creatinine( Cr),blood urea nitrogen( BUN) and creatinine clearance rate( CGr) and 24 h urinary protein quantity were detected. The nocturnal urine output and the number of nocturnal urination before and after treatment. Results The urine NAG enzyme,microalbuminuria,blood uric acid,the number of nocturnal urination,the nocturnal urine output and the scores of blood stasis syndrome were reduced after treatment in the treatment group( P < 0. 05). The urine NAG enzyme and microalbuminuria were reduced after treatment in the control group( P <0. 05). The microalbuminuria,the number of nocturnal urination after treatment in the treatment group were lower than that in the control group( P < 0. 05). The scores of lumbar spinal pain,waist tingling and the number of nocturnal urination and the total scores after treatment were reduced in the treatment group( P < 0. 05). The score of aist tingling and the total scores after treatment in the treatment group were lower than that in the control group( P < 0. 05).Conclusion Xiayuxue decoction has exact effects on reducing nocturia increased hypertensive kidney damage,reduce the number of nocturia,and it has the effects of reducing the number of nocturnal urination,improving the quality of life of patients and lowering blood uric acid,with no obvious adverse reactions.

关 键 词：高血压 肾性 中药疗法 多尿 

分 类 号：R544.145[医药卫生—心血管疾病] R692.053.1[医药卫生—内科学]