加味参芪地黄汤联合厄贝沙坦片治疗高血压肾病临床研究  

Clinical Study on Modified Shenqi Dihuang Tang Combined with Irbesartan Tablets for Hypertensive Nephropathy

作　　者：李达 车志英[2] LI Da;CHE Zhiying

机构地区：[1]郑州市第九人民医院中医科,河南郑州450053 [2]河南中医药大学中医诊断学教研室,河南郑州450000

出　　处：《新中医》2021年第23期67-70,共4页New Chinese Medicine

基　　金：国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医人教发[2016]42号)。

摘　　要：目的:观察加味参芪地黄汤联合厄贝沙坦片对高血压肾病患者尿蛋白及血压等指标的调控效果。方法:选取高血压肾病患者80例,按治疗方式不同分为对照组与观察组各40例。对照组服用厄贝沙坦片治疗,观察组在对照组基础上加服加味参芪地黄汤治疗。2组均连续用药12周,观察2组治疗前后血压、肾功能、尿蛋白等指标的变化。结果:治疗后观察组总有效率82.5%,高于对照组72.5%(P<0.05)。与同组治疗前比较,治疗后2组收缩压、舒张压、尿蛋白排泄率(UAE)、血浆胱抑素C(CysC)及尿素氮(BUN)、尿微量白蛋白(mAlb)、血肌酐(SCr)、β_(2)-微球蛋白(β_(2)-MG)水平均降低(P<0.05),肾小球滤过率(GFR)升高(P<0.05);与对照组治疗后比较,观察组治疗后收缩压、舒张压、UAE、CysC及BUN、mAlb、SCr、β_(2)-MG水平均较低(P<0.05),GFR较高(P<0.05)。结论:加味参芪地黄汤联合厄贝沙坦片能有效改善高血压肾病患者白蛋白指标,改善肾功能,降低血压。Objective:To observe the control effect of modified Shenqi Dihuang tang combined with irbesartan tablets on urinary protein and blood pressure in patients with hypertensive nephropathy.Methods:A total of 80 cases of patients with hypertensive nephropathy were selected and divided into the control group and the observation group according to different treatment methods,with 40 cases in each group.The control group was treated with irbesartan tablets,and the observation group was additionally treated with modified Shenqi Dihuang tang based on the treatment of the control group.Both groups were treated for 12 weeks.Before and after treatment,the changes of indexes of blood pressure,the kidney function and urinary protein were observed.Results:After treatment,the total effective rate was 82.5%in the observation group,higher than that of 72.5%in the control group(P<0.05).After treatment,the systolic and diastolic blood pressure,urinary albumin excretion(UAE),plasma cystatin C(CysC)as well as levels of blood urea nitrogen(BUN),urinary microalbumin(mAlb),serum creatinine(SCr),andβ_(2)-microglobulin(β_(2)-MG)in the two groups were decreased when compared with those before treatment(P<0.05),and the glomerular filtration rate(GFR)was increased(P<0.05);the systolic and diastolic blood pressure,UAE,plasma CysC as well as levels of BUN,urinary mAlb,SCr,andβ_(2)-MG in the observation group were lower than those in the control group(P<0.05),and the GFR was higher(P<0.05).Conclusion:Modified Shenqi Dihuang tang combined with irbesartan tablets can effectively improve the index of albumin and the kidney function as well as reduce the blood pressure in patients with hypertensive nephropathy.

关 键 词：高血压肾病 加味参芪地黄汤 厄贝沙坦片 尿微量白蛋白 尿蛋白排泄率 

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