参芪补肾颗粒对原发性高血压早期肾损害患者的临床疗效、炎症因子、微循环指标的影响

Effect of Shenqi Bushen Granule on Clinical Curative Efficacy, Inflammatory Factors and Microcirculation Index of patients with Early Renal Damage in Essential Hypertension

目的:探讨参芪补肾颗粒治疗高血压病早期肾损害(气虚血瘀证)的临床疗效,分析其作用机制。方法:将100例高血压早期肾损害患者随机分为对照组和观察组各50例。对照组给予西药综合治疗,观察组在对照组的基础上加用参芪补肾颗粒,疗程均为16周。治疗前后检测24 h动态血压、血脂、肾功能、炎症因子、微循环指标,并评价中医单项症状积分及临床疗效。结果:观察组临床疗效总有效率为88.89%,优于对照组的72.33%。治疗后,与对照组比较,观察组中医单项症状疗效均明显优于对照组,24小时动态血压(24h-SBP、24h-DBP、SBPV、DBPV)、肾功能指标(β2-MG、mALB、ACR、Cr、CysC)、血脂指标(TC、TG、LDL-C)、炎症因子(hsCRP、IL-6、TNF-a)均明显降低,微循环指标方面,与治疗前比较,两组治疗后血清一氧化氮(NO)水平均明显升高,血栓素-2(TXB2)、内皮素-1(ET-1)水平均明显降低,与对照组比较,观察组NO水平显著升高,TXB2、ET-1水平显著降低,观察期间两组均无不良反应发生。结论:参芪补肾颗粒治疗高血压早期肾损害,能缓解临床症状、改善肾功能,降低心血管疾病风险,其机制可能与抑制炎症反应、改善微循环有关。

Objective:To investigate the clinical efficacy of Shenqi Bushen Granule in the treatment of early renal damage(Qixuxueyu syndrome)of hypertension,and to analyze its mechanism.Methods:100 patients with early renal damage in hypertension were randomly divided into the control group and the observation group,50 cases in each group.The patients in the control group were treated with comprehensive western medicine,while those in the observation group were treated with Shenqi Bushen Granule combined with comprehensive western medicine which was used in the control group for 16 weeks.24 hours before and after treatment,the ambulatory blood pressure,the blood lipid,the renal function,inflammatory factors and microcirculation were measured,and single symptom score and clinical efficacy of TCM were evaluated.Results:The total effective rate in the observation group was 88.89%,which was better than 72.33%in the control group.After treatment,the curative effect of TCM symptoms in the observation group was better than that in the control group.24-hour ambulatory blood pressure(24 h-SBP,24 h-DBP,SBPV,DBPV),renal function index(beta 2-MG,mALB,ACR,Cr,CysC),blood lipid index(TC,TG,LDL-C),inflammatory factors(hsCRP,IL-6,TNF-a)were lower than those in the control group.For microcirculation indexes,the levels of serum nitric oxide(NO)in both groups after treatment were higher than those before treatment,and the levels of thromboxane-2(TXB2),endothelin-1(ET-1)were lower than those before treatment.The level of NO in the observation group was significantly increased,and the levels of TXB2 and ET-1 were significantly decreased.During the observation,no adverse reactions occurred in both groups.Conclusion:Shenqi Bushen Granule can relieve clinical symptoms,improve renal function and reduce the risk of cardiovascular disease in the treatment of early renal damage in hypertension.Its mechanism may be related to inhibiting inflammation and improving microcirculation.