本文選題：桑芪首烏膏方 + 高血壓早期腎損害　； 參考：《云南中醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:通過觀察桑芪首烏膏方對高血壓早期腎損害患者的中醫(yī)臨床證候、血壓、尿微量白蛋白、尿β2-微球蛋白的影響,以明確桑芪首烏膏方治療高血壓早期腎損害的臨床有效性、安全性,為桑芪首烏膏方防治高血壓早期腎損害提供臨床依據(jù)。方法:選擇72例現(xiàn)代醫(yī)學(xué)診斷符合高血壓早期腎損害[1],中醫(yī)證候符合云南省榮譽(yù)名老中醫(yī)陸家龍教授使用桑芪首烏膏方納入標(biāo)準(zhǔn)的患者,按照隨機(jī)、雙盲原則分為治療組和對照組。兩組均予常規(guī)降壓治療(基礎(chǔ)治療和西藥治療)以維持血壓平穩(wěn)于正常,治療組同時(shí)加服桑芪首烏膏方(每日兩次,每次1袋,每次餐后半小時(shí),加開水100ml攪勻后溫服),對照組同時(shí)加服桑芪首烏膏方模擬方(用法同上)對照,療程均為28天。觀察、分析治療前后兩組的中醫(yī)癥狀積分、血壓(空腹、9點(diǎn)抽血前)、尿微量白蛋白(m Alb)、尿β2-微球蛋白(β2-MG)、安全性觀察指標(biāo)(WBC、RBC、HB、PC、ALT、AST、ALP、Cr、BUN)的變化。結(jié)果:兩組患者治療前性別、年齡、病程、癥狀總積分、各單項(xiàng)癥狀積分、血壓、尿微量白蛋白、β2-微球蛋白等一般情況比較,無統(tǒng)計(jì)差異(P0.05)。治療后治療組總有效率為97.15%,優(yōu)于對照組的61.11%,兩組間比較有統(tǒng)計(jì)差異(P0.05)。治療組治療后癥狀總積分與治療前比較,有顯著統(tǒng)計(jì)差異(P0.01);對照組治療后癥狀總積分與治療前比較,有統(tǒng)計(jì)差異(P0.05);兩組治療后癥狀總積分組間比較,有統(tǒng)計(jì)差異(P0.05)。治療組治療前后自身比較,眩暈、夜尿頻多、腰酸、膝軟、耳鳴、心悸、口干、口苦、失眠、便秘癥狀改善有顯著統(tǒng)計(jì)差異(P0.01),氣短、納差癥狀改善有統(tǒng)計(jì)差異(P0.05);對照組治療前后自身比較,眩暈、納差癥狀改善有顯著統(tǒng)計(jì)差異(P0.01),腰酸、心悸、口干、口苦癥狀改善有統(tǒng)計(jì)差異(P0.05);治療后兩組間比較,夜尿頻多、腰酸、膝軟、納差、失眠癥狀改善有顯著統(tǒng)計(jì)差異(P0.01),口苦、便秘癥狀改善有統(tǒng)計(jì)差異(P0.05)。兩組治療后收縮壓、舒張壓與治療前比較均無統(tǒng)計(jì)差異(P0.05);兩組治療后收縮壓、舒張壓組間比較無統(tǒng)計(jì)差異(P0.05)。治療組治療后尿微量白蛋白、尿β2-微球蛋白與治療前比較,有顯著統(tǒng)計(jì)差異(P0.01);對照組治療后尿微量白蛋白、尿β2-微球蛋白與治療前比較,無統(tǒng)計(jì)差異(P0.05);兩組治療后尿微量白蛋白組間比較有顯著統(tǒng)計(jì)差異(P0.01),尿β2-微球蛋白組間比較有統(tǒng)計(jì)差異(P0.05)。治療后血常規(guī)、肝腎功能(WBC、RBC、HB、PC、ALT、AST、ALP、Cr、BUN)等各項(xiàng)指標(biāo)與治療前比較,無統(tǒng)計(jì)差異(P0.05)。結(jié)論:桑芪首烏膏方在西藥控制血壓的基礎(chǔ)上,不僅可以改善高血壓早期腎損害相關(guān)臨床癥狀,對高血壓尿微量白蛋白、尿β2-微球蛋白等腎臟早期損害相關(guān)指標(biāo)的改善作用也是明顯的。提示桑芪首烏膏方對延緩、逆轉(zhuǎn)高血壓早期腎損害的進(jìn)展具有積極的意義,為進(jìn)一步院內(nèi)制劑的研發(fā)提供了臨床依據(jù)。未見不良反應(yīng),值得進(jìn)一步深入研究并推廣。同時(shí)本研究對繼承名老中醫(yī)學(xué)術(shù)思想和經(jīng)驗(yàn)方的傳承發(fā)展方面具有重要意義。
[Abstract]:Objective: To investigate the clinical efficacy and safety of Sanqi Shouwu ointment prescription in the treatment of early renal damage of hypertension by observing the effect of Sanqi Shouwu ointment on the clinical syndromes, blood pressure, microalbuminuria and urinary beta 2- microglobulin in patients with early renal damage. Methods: 72 cases of modern medical diagnosis were selected to meet the early renal damage [1] of hypertension. The TCM syndromes were in accordance with the honorary old traditional Chinese medicine Lu Jialong of Yunnan province. The patients were divided into the treatment group and the control group according to the random, double blindness principle. The two groups were treated with routine antihypertensive treatment (basic treatment and Western Medicine). At the same time, the blood pressure was normal. The treatment group took Sanqi first Polygonum multiflorum (two times a day, 1 bags each time, half an hour after the meal, adding 100ml to stir up the warm clothes). The control group also took Sanqi Shouwu ointment recipe (with the same above) for 28 days. Observation, analysis of the two groups of TCM symptoms scores, blood pressure (empty stomach, 9) M Alb, urinary beta 2- microglobulin (beta 2-MG), safety observation index (WBC, RBC, HB, PC, ALT, AST, ALP, Cr, Cr). Results: there was no statistical difference between the two groups of patients before treatment, such as sex, age, course of disease, total score of symptoms, symptom integral, blood pressure, microalbumin, beta microglobulin, etc. (P0.05) after treatment, the total effective rate of the treatment group was 97.15%, superior to 61.11% in the control group, and there was a statistical difference between the two groups (P0.05). The total score of the treatment group was compared with that before treatment (P0.01); the total score of the control group after treatment was compared with that before treatment (P0.05); the total score of the symptom after treatment was the total score of the treatment group. There were statistical differences (P0.05). The treatment group was compared before and after treatment, vertigo, night urine frequency, waist acid, knee soft, tinnitus, palpitation, mouth dry, pain, insomnia, and constipation symptoms improved significantly (P0.01), shortness of breath, and the improvement of the symptoms of difference (P0.05); the control group was compared before and after the treatment, dizziness, and the symptoms of differential symptoms improved significantly. Statistical difference (P0.01), lumbar acid, palpitation, dry mouth, pain symptoms improved statistical difference (P0.05); after treatment, the two groups, night urine frequency, waist acid, knee soft, Na difference, insomnia improvement has significant statistical difference (P0.01), oral pain, constipation symptoms improved statistical difference (P0.05). The two groups after treatment systolic pressure, diastolic pressure, and diastolic pressure were no more than before treatment Statistical difference (P0.05); there was no statistical difference between the two groups after treatment, and there was no statistical difference between the treatment group and the diastolic pressure group (P0.05). There were significant statistical differences (P0.01) in the urine microalbumin and urine beta 2- microglobulin in the treatment group after treatment. There was no statistical difference between the control group after treatment and the comparison between the urine beta 2- microglobulin and the pre treatment group (P0.05); There were significant statistical differences (P0.01) among the urine microalbumin groups after treatment (P0.05). After treatment, the indexes of blood routine, liver and kidney function (WBC, RBC, HB, PC, ALT, AST, ALP, Cr, BUN) were compared with those before treatment. Conclusion: Sanqi Shouwu cream is the basis for controlling blood pressure in western medicine. On the other hand, it can not only improve the clinical symptoms related to early renal damage in hypertension, but also improve the early renal damage related indexes, such as microalbuminuria and urinary beta 2- microglobulin, which suggests that Sanqi first Polygonum multiflorum has a positive significance for the delay and reverses the early renal damage in hypertension. There is no adverse reaction, it is worth further research and promotion. Meanwhile, this study is of great significance to inheriting the inheritance and development of the academic thought and experience of the old traditional Chinese medicine.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

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