滋生青阳汤防治高血压早期肾损害的疗效及对血压昼夜节律影响

The Efficacy of Zisheng Qingyang Decoction in Pr eventing and Treating Early Renal Damage in Hypertension and its Impact on Blood Pr essure Circadian Rhythm

目的:观察孟河医派滋生青阳汤防治高血压早期肾损害的疗效及对血压昼夜节律影响。方法:将符合标准的80例确诊为高血压早期肾损害的患者随机分为观察组和对照组,每组各 40 例。对照组给予奥美沙坦氨氯地平常规治疗,观察组在对照组的基础上加用滋生青阳汤治疗。比较2组的临床疗效、中医症候疗效及胱抑素 C(Cys-C)、尿微量白蛋白(mALB)、尿β-微球蛋白水平。结果:观察组中医症候总有效率高于对照组,差异有统计学意义(P<0.05)。2组治疗前 Cys-C、尿β-微球蛋白及尿 mAlb 水平无明显差异(P>0.05);治疗8周后,观察组的 Cys-C 、尿β-微球蛋白及尿mAlb水平均低于对照组,差异有统计学意义(P<0.05)。2组组内比较,治疗 8周后对照组和观察组的Cys-C、尿β-微球蛋白及尿 mAlb 水平均低于治疗前,差异有统计学意义(P<0.05)。2组患者治疗前血压水平无差别,治疗后,观察组 24 h平均收缩压和 24 h平均舒张压水平低于对照组;2组患者治疗前血压昼夜节律无差别,治疗后,观察组杓型血压患者高于对照组,差异有统计学意义(P<0.05)。结论:滋生青阳汤联合西药常规治疗对早期高血压肾损害具有较好治疗效果,能够明显改善患者中医症状和肾功能,还可以调节血压昼夜节律,值得临床推荐。

Objective: To observe the efficacy of Zisheng Qingyang Decoction of Menghe Medical School in prevent-ing and treating early renal damage of hypertension and its effect on the circadian rhythm of blood pressure. Methods: 80 patients who met the criteria and were diagnosed with early renal damage due to hypertension were randomly divided into an observation group and a control group, with 40 cases in each group. The control group was given routine treat-ment with Olmesartan and Amlodipine, while the observation group was given Zisheng Qingyang Decoction on the basis of the control group. The clinical efficacy, TCM symptom efficacy, and cystatin C (Cys-C), urinary mAlb, and urinary β-microglobulin levels were compared between the 2 groups. Results: The total effective rate of TCM symptoms in the observation group was higher than that in the control group, and the difference was statistically significant (P<0.05). There was no significant difference in the levels of Cys-C, urinary β-microglobulin and urinary mAlb between the two groups before treatment (P>0.05);after 8 weeks of treatment, the levels of Cys-C, urinary β-microglobulin and urinary mAlb in the observation group were all the same. Lower than the control group, the difference was statistically signifi-cant (P<0.05). Intra-group comparison between the 2 groups showed that after 8 weeks of treatment, the levels of Cys-C, urinary β-microglobulin and urinary mAlb in the control group and the observation group were lower than before treatment, and the differences were statistically significant (P<0.05). There was no difference in blood pressure levels between the two groups of patients before treatment. After treatment, the 24-h average systolic blood pressure and 24-h average diastolic blood pressure levels of the observation group were lower than those of the control group;there was no difference in the circadian rhythm of blood pressure between the two groups of patients before treatment. After treat-ment, the observation group had a dipper type The blood pressure in patients was higher than that in the control group, and the difference was statistically significant (P<0.05). Conclusion: Zisheng Qingyang Decoction combined with con-ventional Western medicine treatment has a good therapeutic effect on early-stage hypertensive renal damage. It can significantly improve patients’ traditional Chinese medicine symptoms and renal function, and can also regulate the circadian rhythm of blood pressure, which is worthy of clinical recommendation.