潜阳育阴颗粒治疗阴虚阳亢型高血压早期肾损害患者的临床研究
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摘要
目的观察潜阳育阴颗粒对阴虚阳亢型高血压早期肾损害患者的临床疗效。方法将60例阴虚阳亢型老年高血压早期肾损害病例,随机分为对照组(30例)和观察组(30例),对照组常规使用西药氨氯地平(或者联合缬沙坦)降压,观察组在对照组降压治疗维持达标的基础上服用中药潜阳育阴颗粒。24周后比较2组患者治疗前后的临床疗效、单光子发射计算机化体层显像术(SPECT)检测肾小球滤过率(GFR)和胱抑素C(Cyst-C)、尿β_2微球蛋白(β_2-MG)以及尿N-乙酰-β-D葡萄糖苷酶(NAG)等早期肾损害指标的变化情况。结果治疗后观察组和对照组的有效率分别为96%和50%,2组比较有显著性差异,P<0.01;2组肾损害指标Cyst-C、β_2-MG水平均有显著改善(P<0.05),观察组较对照组改善效果更为显著(P<0.05);观察组肾损害指标(GFR、NAG)有显著改善(P<0.05);观察组优于对照组(P<0.05)。结论潜阳育阴颗粒在降压达标基础上能够有效减少高血压患者的早期肾脏损害,改善临床症状。
OBJECTIVE To observe the clinical effect of Qianyang Yuyin granules treating early renal damage patients with yin deficiency and yang hyperactivity type hypertension. METHODS 60 elderly early renal damage patients with yin deficiency and yang hyperactivity type hypertension were randomly divided into two groups: the control group(30 cases) and the observation group(30 cases). In the control group, western medicine amlodipine(or combined with valsartan) was given to reduce blood pressure. The observation group wasn't given Qianyang Yuyin granules until the reduced hypertension adhered to the standard on the basis of those medications used in the control group. 24 weeks later, in addition to comparing the clinical efficacy of the two groups, the research also compared the changes of the early renal damage indexes: glomerular filtration rate(GFR) detected by single photon emission computed tomography(SPECT), cystatin C(Cyst-C), urinary β_2 microglobulin(β_2-MG), urine N-acetyl-β-D glycosidase(NAG) and so forth. RESULTS After treatment, the effective rates of the observation group and the control group were 96% and 50% successively, of which differences were significant(P<0.01). The levels of the early renal damage indexes, Cyst-C and β_2-MG, in the two groups were significantly improved(P<0.05), and the improvement effect in the observation group was more significant than that in the control group(P<0.05). The renal damage indexes(GFR, NAG) in the observation group were significantly improved(P<0.05), and were superior to that in the control group(P< 0.05). CONCLUSION Qianyang Yuyin granules can effectively reduce the early renal damage for hypertension patients on the basis of the reduced hypertension adhering to the standard and improve the clinical symptoms.
OBJECTIVE To observe the clinical effect of Qianyang Yuyin granules treating early renal damage patients with yin deficiency and yang hyperactivity type hypertension. METHODS 60 elderly early renal damage patients with yin deficiency and yang hyperactivity type hypertension were randomly divided into two groups: the control group(30 cases) and the observation group(30 cases). In the control group, western medicine amlodipine(or combined with valsartan) was given to reduce blood pressure. The observation group wasn't given Qianyang Yuyin granules until the reduced hypertension adhered to the standard on the basis of those medications used in the control group. 24 weeks later, in addition to comparing the clinical efficacy of the two groups, the research also compared the changes of the early renal damage indexes: glomerular filtration rate(GFR) detected by single photon emission computed tomography(SPECT), cystatin C(Cyst-C), urinary β_2 microglobulin(β_2-MG), urine N-acetyl-β-D glycosidase(NAG) and so forth. RESULTS After treatment, the effective rates of the observation group and the control group were 96% and 50% successively, of which differences were significant(P<0.01). The levels of the early renal damage indexes, Cyst-C and β_2-MG, in the two groups were significantly improved(P<0.05), and the improvement effect in the observation group was more significant than that in the control group(P<0.05). The renal damage indexes(GFR, NAG) in the observation group were significantly improved(P<0.05), and were superior to that in the control group(P< 0.05). CONCLUSION Qianyang Yuyin granules can effectively reduce the early renal damage for hypertension patients on the basis of the reduced hypertension adhering to the standard and improve the clinical symptoms.
引文
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[10] 段光堂,王慧敏,裴朝华,等.补肾化瘀泄浊法为主治疗高血压性肾损害的临床观察[J].中国中医药科技,2010,17(5):440-441.
[11] 许顶立,任昊.高血压病肾脏损害的诊断与防治[J].中华心血管病杂志,2004,32(2):190-192.
[2] 马迎春,左力,张春丽,等.肾动态显像法测定肾小球滤过率在肾功能不同分期中的适用性[J].中华医学杂志,2006,86(5):351-353.
[3] 方祝元,丁康,沈竹阳,等.潜阳育阴颗粒对自发性高血压大鼠肾脏氧化应激及炎症因子的影响[J].中国实验方剂学杂志,2016,22(13):86-91.
[4] 陈艺,方祝元,严士海,等.潜阳育阴颗粒含药血清对AngⅡ诱导人脐静脉内皮细胞凋亡及fas/fasL蛋白表达的影响[J].中成药,2013,35(7):1381-1385.
[5] 冯昱斌.基于AngⅡ/MAPK通路探讨潜阳育阴颗粒改善高血压肾损害的实验研究[D].南京:南京中医药大学,2015.
[6] 《中国高血压防治指南》修订委员会.中国高血压防治指南2018年修订版[J].心脑血管病防治,2019,19(1):1-3.
[7] 中药新药临床研究指导原则(试行)[J].北京:中国医药出版社,2002:73-76.
[8] 杜明华,刘璐,王平.SPECT快速法测定肾小球滤过率的研究[J]铁道医学,1994,22(4):18-19.
[9] 杨帆,戴小华,王建彬.原发性高血压早期肾损害中医证候学观察[J].安徽中医学院学报,2007,26(2):8-11.
[10] 段光堂,王慧敏,裴朝华,等.补肾化瘀泄浊法为主治疗高血压性肾损害的临床观察[J].中国中医药科技,2010,17(5):440-441.
[11] 许顶立,任昊.高血压病肾脏损害的诊断与防治[J].中华心血管病杂志,2004,32(2):190-192.