益气固肾方联合缬沙坦治疗高血压病早期肾损害夜尿增多临床观察

Clinical study on efficacy of Yiqi Gushen Decoction combined with valsartan on nocturnal polyuria caused by early renal damage in essential hypertension

目的:观察益气固肾方联合缬沙坦治疗高血压病早期肾损害夜尿增多的临床疗效。方法:采用随机数字表法将64例患者随机分为对照组和治疗组各32例。两组均予缬沙坦胶囊及西医基础治疗;治疗组在此基础上加服益气固肾方,对照组加金水宝胶囊。4周为1个疗程,两组患者均连续治疗2个疗程,共8周。观察两组治疗前后中医证候积分、夜尿情况(夜尿量、夜间多尿指数、夜尿尿比重)、早期肾损害实验室指标(微量白蛋白尿、尿β2微球蛋白、尿N-乙酰-β-D葡萄糖苷酶)及诊室血压变化。结果:治疗组中医证候疗效总有效率84.38%,对照组总有效率为62.50%,治疗组优于对照组(P<0.05),差异有统计学意义;治疗后两组夜尿情况、早期肾损害实验室指标及中医证候积分均明显改善(P<0.05),且治疗组优于对照组(P<0.05),差异有统计学意义;治疗后收缩压、舒张压组内比较,两组均较治疗前明显改善(P<0.05),差异有统计学意义,但两组治疗后组间比较,差异均无统计学意义(P>0.05)。结论:益气固肾方联合缬沙坦治疗高血压病早期肾损害夜尿增多症(肾气不固型),可有效改善患者中医症状、改善夜尿情况、降低早期肾损害实验室指标、降低血压、延缓早期肾损害,且安全性较好。

Objective:To observe the clinical efficacy of Yiqi Gushen Decoction(益气固肾方)combined with Valsartan on nocturnal polyuria caused by early renal damage in essential hypertension.Methods:A total of 64 patients were divided into the control group and the treatment group through random number table method,with 32 cases in each group.Valsartan capsules and western medicine treatment strategy were given to the two groups at the same time.In addition to that,the treatment group was treated with Yiqi Gushen Decoction,and the control group was treated with Jinshuibao capsule.Treatment course for both groups was 8 weeks.TCM syndrome score,nocturnal urine condition(including nocturnal urine volume,nocturnal polyuria index,specific gravity of nocturnal urine),early laboratory indicators(including microalbuminuria,urinaryβ2-microglobulin,urinary N-acetyl-β-D-glucosaminidase)and blood pressure before and after treatment in the two groups were observed.Results:The total effective rate of TCM efficacy of the treatment group was 84.38%,and that of the control group was 62.50%.The effect of the treatment group was better than that of the control group(P<0.05).Compared with the indexes before treatment,nocturnal urine,laboratory indicators of early renal damage and TCM syndromes scores were significantly improved in the two groups(P<0.05),and the treatment group was superior to the control group(P<0.05).Compared with the indexes before treatment,both systolic and diastolic blood pressure were decreased in the two groups(P<0.05),but there was no statistically difference between the two groups.Conclusion:Yiqi Gushen Decoction combined with valsartan has function of alleviating TCM symptoms,improving nocturnal urine,reducing early laboratory indicators and controlling blood pressure.It can postpone the progress of early renal damage,and it is safe in clinic.