摘要
在导师的指导下,本研究结合中医基础理论与现代医学知识,根据高血压病早期肾损害的临床特点,提出了高血压病早期肾损害为肾气虚衰,肾中阴阳失调,肾络瘀血的病机说。以补益肾气、燮理阴阳、活血通络为治疗大法,拟平肾通络降压颗粒,通过临床观察和动物实验,对其治疗高血压病肾损害的作用及其机理进行研究,并与卡托普利对照观察。临床观察发现:平肾通络降压颗粒有平稳的降压作用,明显改善高血压眩晕耳鸣,腰膝酸软,神疲乏力等症状,逆转高血压肾损害,纠正脂代谢紊乱,降低血液粘稠度,且用药安全、不良反应少。动物实验发现:其降低SHR的血压,并有一定的降低心率和镇静作用,其作用有量效关系;此外,能降低血浆ET、升高ON浓度,抑制RAS系统活性,改善性激素平衡的作用,改善高血压引起的肾组织病理改变。结论:平肾通络降压颗粒有平稳、缓和的降压作用,并能逆转高血压病早期肾损害,改善临床症状,其作用是通过多个环节、多个靶点而综合实现的,是治疗高血压病早期肾损害的有效方剂。本研究从理论上深化了中医学对高血压病肾损害的病机的认识,为逆转高血压病早期肾损害提供了新的研究思路和治疗方药,为丰富高血压病的中医治疗做了有益的尝试。
Under the guidance of Professor Guo Weixing, together with the knowledge of both basic theory of TCM and modern medicine, the author puts forward a pathogenesis hypothesis based on the clinical characteristic of early stage damage of kidney caused by EH, which is deficiency of kidney Qi, imbalance between Yin and Yang of the kidney as well as blood stasis in kidney collaterals. The author formulated a preparation PingShenTongLuoJiangYa granule which is used to tonify kidney qi, make a balance between kidney yin and yang, and promote the circulation of blood to remove collaterals obstruction in the kidney. The author has done research to evaluate the treatment effect and the mechanism of decreasing the blood pressure and protecting the kidney through clinical observation and animal testing. The result shows that the study group has achieved a good result in lowering the blood pressure smoothly, improving the signs and symptoms of the patients, such as vertigo, tinnitus, weakness in waist and knees, hypodynamia and so on, reversing the damage of kidney, adjusting the cholesterol level, lowering the viscidity of blood as well as improving safety and lowering adverse effects. In animal testing , we have found out that the granula can lower the blood pressure of SHR rats with some effect of slowing down the heart rate and improving tranquility , descending plasma ET-1 and ascending serum ON , inhibiting the activity of RAS system , improving the level of sexual homeostasis and pathological renal injurie . The conclusion is that the PingShenTongLuoJiangYa granula has the effect of lowering blood pressure stably and mildly, protecting kidney damaged by EH, improving the clinical signs and symptoms. It has been proven to be a useful formula having good effect through several links and target points. This research deeps the TCM comprehension to mechanism of kidney damage of EH , puts forward a new research way and a recipe , makes a good try for TCM to thetreatment of hypertension .
引文
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