本文關(guān)鍵詞： 高血壓病早期腎臟損害 化痰祛瘀 健脾益腎 腎血流　出處：《黑龍江中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過對高血壓病早期腎臟損害患者血壓、尿微量白蛋白及腎臟葉間動脈的收縮期峰速度、舒張期末血流速度、阻力指數(shù)和中醫(yī)證候積分的觀察,探討化痰祛瘀、健脾益腎法對高血壓病早期腎臟損害的臨床療效及對腎血流的影響。方法:選取符合納入標(biāo)準(zhǔn)的高血壓病早期腎臟損害痰瘀互結(jié)型患者80例,將其隨機(jī)分為對照組40例、治療組40例。對照組給予常規(guī)藥物治療,治療組在常規(guī)藥物治療基礎(chǔ)上加用化痰祛瘀、健脾益腎方藥。兩組觀察期限均為3周。觀察兩組患者治療前后收縮壓、舒張壓、尿微量白蛋白及腎臟葉間動脈的收縮期峰速度、舒張期末血流速度、阻力指數(shù)的變化;同時觀察兩組患者治療前后的中醫(yī)證候積分。采用SPSS20.0軟件進(jìn)行統(tǒng)計(jì)分析比較。結(jié)果:1.治療后中醫(yī)證候積分組間比較,治療組明顯優(yōu)于對照組,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。治療后治療組中醫(yī)證候總有效率為90%,明顯優(yōu)于對照組,組間比較差異有統(tǒng)計(jì)學(xué)義(p0.05)。2.兩組治療后收縮壓、舒張壓、尿微量白蛋白均較治療前下降,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。治療后兩組收縮壓、舒張壓、尿微量白蛋白組間比較,治療組明顯優(yōu)于對照組,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。3.治療組治療后腎臟葉間動脈的收縮期峰速度、舒張期末血流速度較治療前明顯加快,阻力指數(shù)較治療前明顯下降,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。對照組收縮期峰速度、舒張期末血流速度較治療前明顯加快,阻力指數(shù)較治療前明顯下降,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。治療后收縮期峰速度、舒張期末血流速度、阻力指數(shù)組間比較,治療組優(yōu)于對照組,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。結(jié)論:1.化痰祛瘀、健脾益腎法可改善高血壓病早期腎臟損害患者的中醫(yī)臨床癥狀。2.化痰祛瘀、健脾益腎法可降低高血壓病早期腎臟損害患者的血壓及尿微量白蛋白水平。3.化痰祛瘀、健脾益腎法可增加高血壓病早期腎臟損害患者腎臟葉間動脈的收縮期峰速度及舒張期末血流速度,降低阻力指數(shù),對高血壓導(dǎo)致的腎血流減少有改善作用。
[Abstract]:Objective: to observe the blood pressure, urinary microalbumin, systolic peak velocity, end-diastolic velocity, resistance index and TCM syndrome score of renal interlobar artery in patients with early renal injury of essential hypertension (EH), and to explore the effect of removing phlegm and removing blood stasis. Clinical effect of invigorating spleen and tonifying Kidney on Renal damage and its influence on Renal Blood flow in patients with Hypertension methods: 80 patients with early renal damage and phlegm and blood stasis were randomly divided into control group (n = 40). 40 cases in the treatment group. The control group was treated with routine medicine, and the treatment group was treated with the prescription of removing phlegm and removing blood stasis and tonifying spleen and tonifying kidney on the basis of routine medicine. The observation period of both groups was 3 weeks. The systolic blood pressure and diastolic blood pressure were observed before and after treatment in both groups. Changes of urinary microalbumin, peak systolic velocity of renal interlobar artery, end-diastolic blood flow velocity and resistance index; At the same time, we observed the TCM syndromes integral before and after treatment in the two groups. The SPSS20.0 software was used to make statistical analysis and comparison. Results: 1. After treatment, the treatment group was obviously better than the control group. After treatment, the total effective rate of TCM syndromes in the treatment group was 90, which was obviously superior to that in the control group, and the difference between the two groups was statistically significant (P 0.05). The systolic blood pressure, diastolic blood pressure and urinary microalbuminuria in the two groups were all decreased after treatment. After treatment, the systolic blood pressure, diastolic blood pressure and urinary microalbuminuria in the treatment group were significantly better than those in the control group, and the difference was statistically significant (p 0.05) .3.The systolic peak velocity of the renal interlobar artery after treatment in the treatment group was significantly higher than that in the control group. The blood flow velocity at the end of diastolic period was faster than that before treatment, and the resistance index was lower than that before treatment, the difference was statistically significant (p 0.05). The peak systolic velocity and blood flow velocity at end diastolic period in the control group were significantly faster than those before treatment. The resistance index was significantly lower than that before treatment, and the difference was statistically significant (p 0.05). The peak systolic velocity, end-diastolic blood flow velocity and resistance index were better in the treatment group than in the control group, and the difference was significant (p 0.05). Conclusion: 1. Removing phlegm and removing blood stasis, the resistance index in the treatment group is better than that in the control group. The method of invigorating spleen and tonifying kidney can improve the clinical symptoms of traditional Chinese medicine (TCM) in patients with renal damage in early stage of hypertension. 2. Removing phlegm and removing blood stasis, strengthening spleen and tonifying kidney can reduce the blood pressure and the level of urinary microalbuminuria of patients with early renal damage of essential hypertension, and expelling phlegm and removing blood stasis. The method of invigorating spleen and tonifying kidney can increase the systolic peak velocity and end-diastolic blood flow velocity of renal interlobar artery in patients with early renal damage and decrease resistance index, which can improve the decrease of renal blood flow induced by hypertension.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R544.1

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