益气化痰活血法干预中老年原发性高血压气虚痰瘀证患者早期肾损害临床观察

Clinical observation of Yiqihuatanhuoxue prescription on early renal damage of qi deficiency and phlegm stagnation syndrome hypertension

目的观察益气化痰活血法治疗中老年原发性高血压气虚痰瘀、痰湿壅盛证(简称气虚痰瘀证)患者早期肾损害的临床疗效及对患者纤维蛋白原(FIB)、D-二聚体及血、尿β2-微球蛋白(β2-MG)的影响。方法将220例原发性高血压气虚痰瘀证患者随机分为2组。对照组110例予西医常规治疗,治疗组110例在对照组治疗基础上加用益气化痰活血中药复方汤剂。疗程12周,观察2组治疗前后症状积分、血压、FIB、D-二聚体及血、尿β2-MG变化。结果治疗组总有效率75.5%,对照组总有效率78.2%,2组比较差异无统计学意义(P>0.05);2组治疗后收缩压、舒张压、中医症状积分、FIB及血、尿β2-MG均降低(P<0.01,P<0.05);与对照组相比,治疗组血、尿β2-MG降低明显(P<0.05),其他指标2组比较差异无统计学意义(P>0.05)。结论益气化痰活血中药复方汤剂能有效降低气虚痰瘀证中老年原发性高血压患者的血压,减轻高凝状态,减轻早期肾损害。

Objective To observe the effect of Yiqihuatanhuoxue prescription on early renal damage and Fi- brinogen, D - Ⅱ mer, hematuria β2 - microglobulin of qi deficiency and phlegm stagnation syndrome hypertension. Methods 220 qi deficiency and phlegm stagnation syndrome hypertension patients were randomly divided into two groups. 110 patients in control group received routine therapy. 110 cases in treatment group received a decoction for Yiqihuatanhuoxue prescription combined with routine therapy. The course was 12 weeks. The changes of symptom score, blood pressure, fibrinogen, D - Ⅱ mer and blood, urine β2 - microglobulin before and after treatment were observed. Results The total effective rate in the experimental group was 75.5%, that of the control group was 78.2%, there was no difference between two groups （ P 〉 0.05 ）. Systolic blood pressure, diastolic blood pressure, symptom score, fibrinogen and urine β2 -microglobulin after treatment were reduced in two groups （P 〈 O. 01, P 〈 0.05 ）. Compared with that in control group, blood and urine β2- microglobulin in treatment group were obviously de- creased after treatment （P 〈 0.05 ）. There was no significant difference between two groups on the others indexes （P 〉 0.05）. Conclusion Yiqihuatanhuoxue prescription can effectively reduce hypertension blood pressure of qi deficiency and phlegm stagnation syndrome senile hypertension patients, the high coagulation state and the early renal damage.