健脾益肾摄精化瘀汤联合厄贝沙坦治疗高血压肾病的疗效及对炎症因子的影响  

Therapeutic Effect of Jianpi Yishen Shejing Huayu Decoction Combined with Irbesartan on Hypertensive Nephropathy and Its Effect on Inflammatory Factors

作　　者：曾未琪 饶克瑯 ZENG Wei-Qi;RAO Ke-Lang(Bao’an Traditional Chinese Medicine Hospital Affiliated to Guangzhou University of Chinese medicine,Shenzhen 518101 Guangdong,China;Dept.of Nephrology,Bao’an Traditional Chinese Medicine Hospital Affiliated to Guangzhou University of Chinese medicine,Shenzhen 518101 Guangdong,China)

机构地区：[1]广州中医药大学附属宝安中医院,深圳宝安518101 [2]广州中医药大学附属宝安中医院肾病科,深圳宝安518101

出　　处：《广州中医药大学学报》2020年第4期600-605,共6页Journal of Guangzhou University of Traditional Chinese Medicine

摘　　要：【目的】观察健脾益肾摄精化瘀汤联合厄贝沙坦治疗高血压肾病(脾肾气虚夹瘀型)的临床疗效及对炎症因子的影响。【方法】将72例患者随机分为观察组和对照组,每组各36例。2组患者均给予西医常规治疗,对照组同时给予厄贝沙坦片口服治疗,观察组在对照组基础上给予健脾益肾摄精化瘀汤口服治疗,共治疗4周。观察2组患者治疗前后中医证候积分、血压[收缩压(SBP)和舒张压(DBP)]、尿微量白蛋白(m ALB)、血β2微球蛋白(β2-MG)及炎症因子[白细胞介素6(IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)]水平的变化情况,评价2组患者的中医证候疗效及安全性。【结果】(1)中医证候疗效方面:治疗4周后,观察组的总有效率为94.4%,对照组为69.4%,观察组的中医证候疗效明显优于对照组(P<0.05)。(2)观察指标方面:治疗后,2组患者的中医证候积分、血压(SBP和DBP)、血β2-MG、尿m ALB和血清IL-6、TNF-α、hs-CRP水平均较治疗前明显降低(P<0.05),且观察组的降低作用均明显优于对照组,差异均有统计学意义(P<0.05)。(3)安全性方面:观察组的不良反应发生率为8.3%,对照组为25.0%,观察组的不良反应发生率明显低于对照组,差异有统计学意义(P<0.05)。【结论】健脾益肾摄精化瘀汤联合厄贝沙坦治疗脾肾气虚夹瘀型高血压肾病疗效显著,不仅能降低血压,减轻中医证候,还能改善肾功能,减少尿蛋白,而且不良反应比单纯西药治疗明显减少,其机制可能与抑制机体炎症反应有关。Objective To investigate the clinical efficacy of Jianpi Yishen Shejing Huayu Decoction,a Chinese herbal prescription with the actions of invigorating spleen,nourishing kidney,arresting essence and resolving stasis,combined with irbesartan for the treatment of hypertensive nephropathy with the syndrome of spleen-kidney qi deficiency complicated with stasis,and to observe its effect on the inflammatory factors.Methods A total of 72 hypertensive nephropathy patients with the syndrome of spleen-kidney qi deficiency complicated with stasis were randomly divided into control group and observation group,36 cases in each group.Both groups were given conventional western medicine treatment,and additionally,the control group was given oral use of irbesartan tablets,and the observation group was treated with Jianpi Yishen Shejing Huayu Decoction combined with irbesartan orally.The treatment for the two groups covered 4 weeks.Before and after treatment,the scores of traditional Chinese medicine syndrome,blood pressure indexes of systolic blood pressure(SBP)and diastolic blood pressure(DBP),urinary microalbumin(mALB),bloodβ2 microglobulin(β2-MG),and inflammatory factors such as interleukin-6(IL-6),hypersensitive C-reactive protein(hs-CRP),and tumor necrosis factor alpha(TNF-α)in the two groups were observed.After treatment,the clinical efficacy on TCM syndromes and the clinical safety of the two groups were compared.Results(1)After treatment for 4 weeks,the total effective rate of TCM syndromes in the observation group was 94.4%,which was significantly different from that in the control group(69.4%,P<0.05).(2)After treatment,the scores of TCM syndromes,blood pressure of SBP and DBP,bloodβ2-MG,urinary mALB,and serum IL-6,TNF-αand hs-CRP levels in the two groups were much decreased in comparison with those before treatment(P<0.05),and the decrease in the observation group was superior to that in the control group,the difference being statistically significant(P<0.05).(3)The adverse reaction incidence rate in the observati

关 键 词：健脾益肾摄精化瘀汤 厄贝沙坦 高血压肾病 脾肾气虚夹瘀型 炎症因子 

分 类 号：R259.4414[医药卫生—中西医结合]