左归丸联合西药治疗高血压早期肾损害肾精不足证临床研究

Clinical Study on Zuogui Pills Combined with Western Medicine for Early Kidney Damage from Hypertension with Syndrome of Kidney Essence Insufficiency

目的:观察左归丸联合西药治疗高血压早期肾损害肾精不足证患者的临床疗效。方法:采用随机数字表法将100例患者分为观察组和对照组各50例。2组均口服厄贝沙坦片治疗,若血压未达标,则加用苯磺酸氨氯地平片治疗。观察组加用左归丸加减方治疗。2组均连续治疗12周。治疗前、治疗12周后检测β_(2)微球蛋白(β_(2)-MG)、尿N-乙酰-β-氨基葡萄糖苷酶(NAG)、尿微量白蛋白(mAlb)、血胱抑素C(CysC)水平,评定肾精不足证评分;每天测量血压,记录血压达标情况。结果:治疗后,2组β_(2)-MG、NAG、CysC及mAlb水平均较治疗前下降(P<0.01),观察组β_(2)-MG、NAG、CysC及mAlb水平均低于对照组(P<0.01)。2组肾精不足证评分均较治疗前下降(P<0.01),观察组肾精不足证评分低于对照组(P<0.01)。治疗期间,观察组的血压达标率为89.60%,对照组为83.67%,2组比较,差异有统计学意义(P<0.01)。结论:在常规西药治疗基础上加用左归丸加减方治疗高血压早期肾损害肾精不足证患者,可有效保护肾功能、控制血压,减轻临床症状。

Objective:To observe the clinical effect of the therapy of Zuogui pills combined with western medicine on patients with early kidney damage from hypertension with syndrome of kidney essence insufficiency.Methods:A total of100 patients were divided into the observation group and the control group,50 cases in each group according to random number table method.Both groups were treated with irbesartan tablets orally,and amlodipine benzenesulfonate tablets were added if the blood pressure was not up to standard.The observation group was additionally treated with modified Zuogui pills.Both groups were treated for twelve weeks.The levels ofβ_(2) microglobulin(β_(2)-MG),urinary N-acetyl-β-glucosaminosidase(NAG),urinary microalbumin(mAlb)and blood cystatin C(CysC)were detected before and 12 weeks after treatment,and the score of kidney essence insufficiency was assessed.The blood pressure was measured every day and blood pressure compliance was recorded.Results:After treatment,the levels ofβ_(2)-MG,NAG,CysC and mAlb in both groups were decreased when compared with those before treatment(P<0.01);the above levels in the observation group were lower than those in the control group(P<0.01).The scores of kidney essence insufficiency in both groups were decreased when compared with those before treatment(P<0.01),and the above score in the observation group was lower than that in the control group(P<0.01).During treatment,the blood pressure compliance rate was 89.60%in the observation group and83.67%in the control group,the difference being significant(P<0.01).Conclusion:On the basis of the conventional western medicine,the additional application of modified Zuogui pills can effectively protect the kidney function,control blood pressure and alleviate clinical symptoms in the treatment of patients with early kidney damage from hypertension with syndrome of kidney essence insufficiency.