平肝滋肾方治疗高血压视网膜病变临床研究  

Clinical Study on Treatment of Hypertensive Retinopathy with Pinggan Zishen Formula(平肝滋肾方)

作　　者：裴朝华 曹岩 王鹏 方芳 弭澜 PEI Chaohua;CAO Yan;WANG Peng;FANG Fang;MI Lan(Department of Nephrology,Tangshan Hospital Traditional Chinese Medicine,Tangshan 063099,China;Department of Cardiology,Tangshan Hospital of Traditional Chinese Medicine,Tangshan 063099,China)

机构地区：[1]唐山市中医医院肾病科,河北唐山063099 [2]唐山市中医医院心血管科,河北唐山063099

出　　处：《山东中医杂志》2023年第6期576-582,共7页Shandong Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(编号:2018314)。

摘　　要：目的:探讨平肝滋肾方治疗高血压视网膜病变的疗效,及对心肾微循环、血管内皮的影响。方法:用随机数字表法将260例高血压视网膜病变患者分为观察组和对照组各130例。对照组采用常规对症治疗,观察组在此基础上服用平肝滋肾方。两组患者均连续治疗3个月,疗程结束后对比疗效。比较两组患者治疗前后中医证候积分、心功能指标、肾功能指标、组织因子(TF)、组织因子途径抑制物(TFPI)、载脂蛋白M(ApoM)、脂蛋白磷脂酶A2(Lp-PLA2)表达水平。结果:治疗后两组各项症状评分及中医证候积分总分均降低(P<0.05),且观察组低于对照组(P<0.05);观察组总有效率95.38%,对照组88.46%,观察组疗效优于对照组(P<0.05);治疗后两组心功能均改善(P<0.05),且观察组左心室射血分数高于对照组、左心室质量指数低于对照组(P<0.05);治疗后两组肾功能指标均改善(P<0.05),且观察组较对照组改善更明显(P<0.05);治疗后两组TF、Lp-PLA2均降低(P<0.05),且观察组低于对照组(P<0.05),两组ApoM水平均升高,且观察组高于对照组(P<0.05);治疗后两组TFPI水平比较,差异无统计学意义(P>0.05)。结论:平肝滋肾方治疗高血压视网膜病变疗效明确,能够改善心肾微循环,减轻血管内皮损伤。Objective:To investigate the therapeutic effect and effects of on the expression of cardio-renal microcirculation and vascular endothelial of Pinggan Zishen Formula(平肝滋肾方)in patients with hypertensive retinopathy.Methods:Total 260 patients with hypertensive retinopathy were randomly divided into observation group and control group by random number table method,with 130 cases in each group.The patients in control group were given conventional treatment,and the patients in observation group were given Pinggan Zishen Formula on this basis.The patients in two groups were treated continuously for 3 months,and the efficacy was compared after the treatment.Traditional Chinese medicine(TCM)syndrome score,cardiac function index,renal function index,tissue factor(TF),tissue factor pathway inhibitor(TFPI),apolipoprotein M(ApoM)and lipid A2(Lp-PLA2)expression levels were compared between the two groups before and after treatment.Results:The score of symptoms and total score of TCM syndrome were decreased in the two groups(P<0.05),and those in the observation group were lower than those in the control group(P<0.05).The total effective rate was 95.38%in the observation group and 88.46%in the control group.The curative effect of the observation group was better than that of the control group(P<0.05).After treatment,cardiac function was improved in both groups(P<0.05),and left ventricular ejection fraction in observation group was higher than that in control group,and left ventricular mass index was lower than that in control group(P<0.05).After treatment,renal function indexes of both groups were improved(P<0.05),and the improvement of observation group was more obvious than control group(P<0.05).After treatment,TF and Lp-PLA2 in two groups were decreased(P<0.05),and the observation group were lower than the control group(P<0.05),The ApoM level in two groups was increased,and the observation group was higher than the control group(P<0.05).There was no statistically significant difference in TFPI level between the two

关 键 词：高血压视网膜病变 平肝滋肾方 心肾微循环 血管内皮损伤 高凝状态 

分 类 号：R259.441[医药卫生—中西医结合]