动态脉压与高血压肾损害的关系及中药干预的作用

Relationship between Ambulatory Pulse Pressure and Hypertensive Renal Damage and Intervention of TCM

目的观察原发性高血压(气虚痰浊型)患者动态脉压与肾脏损害的关系及中药复方芪麻胶囊的干预作用。方法将100例符合标准的高血压病肾损害患者分为50mmHg≤动态脉压<60mmHg和动态脉压≥60mmHg2组,分析动态脉压与肾功能损害的关系。将患者分为治疗组和对照组,治疗组在常规西药的基础上加用芪麻胶囊治疗,对照组仅给予常规西药治疗,12周为1个疗程,治疗2个疗程,观察治疗前后动态血压的变化和对肾功能的影响。结果 50mmHg≤动态脉压<60mmHg的高血压患者(气虚痰浊型)均出现尿微量蛋白等早期肾功能损害表现,并且随着脉压的升高,肾功能损害程度加重。治疗组能明显降低血压(P<0.05),降低尿微量蛋白的排出量(P<0.01),改善肌酐清除率(P<0.05),疗效明显优于对照组(P<0.05～0.01)。结论平均动态脉压与高血压患者(气虚痰浊型)的肾功能损害程度成正比,可作为判断高血压(气虚痰浊型)患者早期肾功能损害的指标。芪麻胶囊具有较好的干预作用。

Objective To observe the relationship between ambulatory pulse pressure and renal damage of primary hypertension （Qi deficiency and phlegm turbidity syndrome） patients, and intervention of Chinese herbal compound Qima capsule. Methods One hundred patients of hypertensive renal damage were divided into 50 mmHg≤ambulatory pulse pressure〈60 mmHg and ambulatory pulse pressure〉 60 mmHg. The relation between ambulatory pulse pressure and renal function damage was analyzed. The patients were divided into treatment group and control group. The treatment group was treated with Chinese herbal compound Qima capsule on the basis of conventional western medicine, and the control group was given conventional western medicine treatment. 12 weeks was a course of treatment. After two courses of treatment, changes of ambulatory blood pressure and the impact on renal function were observed. Results 50 mm Hg≤ambulatory pulse pressure 〈 60 mm Hg in hypertensive patients （Qi deficiency and phlegm turbidity syndrome） suffered from urine microprotein and other manifestations of early renal damage, and the renal damage increased with the increase of pulse pressure. Blood pressure of treatment group was signficantly lowered （P 〈0.05）, urinary protein excretion lowered （P 〈0.01）, creatinine clearance rate improved （P〈0.051, the efficacy was superior to the control group （P〈0.05- 0.01）. Conclusion The average ambulatory pulse pressure of hypertension patients （Qi deficiency and phlegm turbidity syndrome） has positive relation with the degree of renal dysfunction. It can be used as early renal dysfunction indicators of hypertension （Qi deficiency and phlegm turbidity syndrome）. Qima capsule has good intervention effect.