活血利水方联合西药改善高血压病早期肾损害的临床研究

Clinical Study of Huoxue Lishui Decoction Combined with Western Medicine in Improving Early Renal Damage in Patients with Essential Hypertension

目的:探讨活血利水中药方联合西药改善高血压病早期肾损害的临床效果。方法:选择2017年1月—12月在本院诊断治疗高血压病早期损害患者100例为研究对象,随机分为联合组与对照组各50例,对照组采用厄贝沙坦治疗,联合组在此基础上加用活血利水方治疗。比较两组治疗前及治疗8周后血压水平、m ALB、尿β2-MG、血β2-MG、m ALB/Cr、中医证候评分。结果:治疗8周后,联合组收缩压(128. 5±4. 6) mmHg,舒张压(80. 2±2. 0) mmHg;治疗8周后,对照组收缩压(134. 1±4. 2) mmHg,舒张压(86. 3±2. 2) mmHg;两组治疗后收缩压与舒张压均显著低于治疗前,差异有统计学意义(P <0. 05);治疗后联合组收缩压与舒张压水平显著低于对照组,差异有统计学意义(P <0. 05)。治疗8周后,联合组m ALB(0. 22±0. 07) mg/L,尿β2-MG(0. 33±0. 10) mg/L,血β2-MG(1. 68±0. 11) mg/L,m ALB/Cr(1. 24±0. 21);对照组m ALB(0. 43±0. 10) mg/L,尿β2-MG(0. 46±0. 12) mg/L,血β2-MG(1. 97±0. 13) mg/L,m ALB/Cr(1. 45±0. 19);治疗后两组m ALB、尿β2-MG、血β2-MG、m ALB/Cr均显著低于治疗前,差异有统计学意义(P <0. 05);治疗后联合组m ALB、尿β2-MG、血β2-MG、m ALB/Cr水平显著低于对照组,差异有统计学意义(P <0. 05)。治疗前,联合组证候评分(23. 1±6. 6)分,对照组评分(22. 8±7. 1)分;治疗8周后联合组评分(13. 9±2. 1)分,对照组评分(19. 2±3. 3)分;治疗8周后两组证候评分均显著低于治疗前,差异有统计学意义(P <0. 05);治疗后联合组证候评分显著低于对照组治疗后,差异有统计学意义(P <0. 05)。结论:活血利水方联合西药治疗高血压病早期肾损害显著改善血压水平,降低肾功能指标。

Objective:To explore the clinical effect of Huoxue Lishui Decoction combined with western medicine on early renal damage in hypertension.Methods:From January to December 2017,100 patients with early damage of hypertension were randomly divided into the combined group and the control group,50 cases in each group.The control group was treated with irbesartan,and the combined group was treated with Huoxue Lishui Decoction.The blood pressure level,m ALB,urinary beta 2-MG,blood beta 2-MG,m ALB/Cr and TCM syndrome score were compared between the two groups before treatment and 8 weeks after treatment.Results:After 8 weeks treatment,the systolic and diastolic blood pressure(SBP)were(128.5±4.6)mmHg and(80.2±2.0)mmHg in the combined group,and(134.1±4.2)mmHg and(86.3±2.2)mmHg in the control group after 8 weeks treatment.The systolic blood pressure and diastolic blood pressure of the combined group were significantly lower than those of the control group(P<0.05).After 8 weeks treatment,in the combined group,m ALB was(0.22±0.07)mg/L,urinbet2-MG(0.33±0.10)mg/L,blood bet2-MG(1.68±0.11)mg/L and m ALB/Cr(1.24±0.21).In the control group,m ALB was(0.43±0.10)mg/L,urinbet2-2-MG(0.46±0.12)mg/L,blood bet2-2-MG(1.97±0.13)mg/L and m ALB/Cr(1.45±0.19).The two groups’m ALB,urine bet2-2-MG,blood bet2-2-MG and m ALB/Cr were significantly lower than those before treatment(P<0.05),and the levels of m ALB,urinary beta-2-MG,serum beta-2-MG and m ALB/Cr in the combined group were significantly lower than those in the control group(P<0.05).Before treatment,the symptoms score of the combined group was23.1±6.6 and the control group’s 22.8±7.1.After 8 weeks treatment,the combined group’s was 13.9±2.1 and the control group’s 19.2±3.3.After 8 weeks treatment,the symptoms score of the two groups were significantly lower than those before treatment.The difference was statistically significant(P<0.05).After treatment,the symptoms score of the combined group was significantly lower than that before treatment(P<0.05).In the control group,the difference was statistically significant(P<0.05).Conclusion:Huoxue Lishui Decoction combined with western medicine can significantly improve blood pressure and reduce renal function in the treatment of early renal damage in hypertension.