高血压病早期肾损害中医证候的临床观察  

Clinical observation on TCM syndromes of patients with early renal damage after hypertension

作　　者：徐三彬 麻志恒[1] 倪建俐[1] 徐彬[1] XU Sanbin

机构地区：[1]上海交通大学医学院附属新华医院崇明分院,上海202150

出　　处：《中医临床研究》2023年第11期106-110,共5页Clinical Journal Of Chinese Medicine

基　　金：上海市中医药事业发展三年行动计划(ZY-ZWB-1001);上海市卫健委重点项目(ZY-FWTX-6031)。

摘　　要：目的:观察和分析高血压病早期肾损害患者的中医证候分布特点,以指导临床辨证施治。方法:筛选2016年-2018年门诊及病房治疗的原发性高血压病患者240例,根据尿白蛋白与肌酐的比值将纳入的患者分为高血压病早期肾损害(观察组,160例)和无高血压病肾损害(对照组,80例),比较两组患者中医证候积分。结果:与无高血压病肾损害患者相比,高血压病早期肾损害患者的肝肾阴虚及血瘀证候积分显著增高(P<0.05);随着年龄及血压的增加,高血压病早期肾损害患者的肾病和血瘀证的临床表现逐渐明显(P<0.05)。结论:高血压病早期肾损害患者随着年龄的增加,肾脏、气虚、血瘀的证候积分逐渐升高,这可能与衰老、阴阳平衡失调、脏腑功能逐渐衰退有关。原发性高血压病为临床常见病证,多见于中老年人,具有反复发作、时轻时重、病程较长、迁延不愈等特点,其早期肾脏损害发生在数年之后,久病入络,瘀血内生。因此高血压病早期肾损害的病机以肝肾阴虚为本,肾络瘀阻为标。Objective:To observe and analyze the distribution characteristics of TCM syndromes in hypertensive disease patients with early renal damage,so as to guide clinical treatment based on syndrome differentiation.Methods:A total of 240 cases of essential hypertensive disease treated in outpatient and ward from 2016 to 2018 were selected.According to the ratio of urinary albumin to creatinine,the included patients were divided into the hypertensive early renal damage group(namely the observation group,160 cases)and the non-hypertensive renal damage group(namely the control group,80 cases).Results:The scores of the liver and kidney Yin(阴)deficiency syndrome and blood stasis syndrome of hypertensive disease patients with early renal damage were significantly higher than those of hypertensive disease patients without renal damage(P<0.05).With the increase of age and blood pressure,the clinical manifestations of kidney disease and blood stasis syndrome in hypertensive disease patients with early renal damage were gradually obvious(P<0.05).Conclusion:In patients with early renal impairment of hypertension,the syndrome scores of kidney,Qi(气)deficiency and blood stasis gradually increase with age,which may be related to aging,imbalance of Yin and Yang(阳),and gradual decline of internal organ function.Primary hypertension is a common clinical symptom,more common in middle-aged and elderly people,with recurrent attacks,mild and severe,long course of disease,prolongation and other characteristics,its early kidney damage occurs after several years,long-term disease,blood stasis endogenous.The pathogenesis of early renal damage after hypertensive disease is mainly due to Yin deficiency of liver and kidney,with kidney collateral stagnation as the exterior syndrome.

关 键 词：高血压病早期肾损害 中医证候 肝肾阴虚 瘀血 

分 类 号：R544.1[医药卫生—心血管疾病]