【摘要】：目的:在降壓達(dá)標(biāo)基礎(chǔ)上(氨氯地平或聯(lián)合纈沙坦,收縮壓(SBP)"f140mmHg和舒張壓(DBP)"f90mmHg)基于SPECT技術(shù)評(píng)價(jià)潛陽(yáng)育陰顆粒改善高血壓患者早期腎臟損害作用。方法:入選符合陰虛陽(yáng)亢證型的高血壓早期腎損害的住院或門診的60例患者,隨機(jī)分為兩組,每組30例,在規(guī)范降壓方案(氨氯地平5 mg/d,必要時(shí)加量至10 mg/d,或必要時(shí)加用纈沙坦)控制血壓達(dá)標(biāo)基礎(chǔ)上(收縮壓(SBP)"f140mmmHg和舒張壓(DBP)"f90mmmHg),治療組給予潛陽(yáng)育陰顆粒20g,2/日,早晚服用;對(duì)照組為空白對(duì)照不再加用其它保護(hù)腎臟功能的中西藥物,共干預(yù)24周。治療后觀察兩組病人的中醫(yī)證候、實(shí)驗(yàn)室指標(biāo)、血壓、心率。實(shí)驗(yàn)室指標(biāo)為:尿β 2微球蛋白(B2-mG),血清光抑素C(Cyst-C),尿N-乙酰-β-D-葡萄糖苷酶(NAG)及SPECT測(cè)得的腎小球?yàn)V過(guò)率(GFR)。治療結(jié)束后將數(shù)據(jù)輸入SPSS程序中進(jìn)行分析。結(jié)果:1.潛陽(yáng)育陰顆粒對(duì)腎臟損害指標(biāo)的影響:治療組各組腎損害指標(biāo)治療后均明顯改善(P0.05);對(duì)照組治療后Cyst-C、B2-mG改善明顯,有統(tǒng)計(jì)學(xué)差異(P0.05);對(duì)照組NAG、GFR未見改善,無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);治療組與對(duì)照組治療后比較,治療組較對(duì)照組改善明顯(P0.05)。2.中醫(yī)證候療效方面:中醫(yī)證候總積分治療組治療后明顯降低(P0.05),具有統(tǒng)計(jì)學(xué)意義;對(duì)照組治療后明顯降低(P0.05),具有統(tǒng)計(jì)學(xué)意義;治療組與對(duì)照組治療后比較改善明顯(P0.01),有極顯著差異。各組癥狀中醫(yī)證候積分治療組治療后除健忘外其余中醫(yī)證候積分均明顯降低(P0.01),具有極顯著差異;對(duì)照組除膝軟、健忘、舌苔、細(xì)脈外治療后中醫(yī)證候積分均降低(P0.05),具有統(tǒng)計(jì)學(xué)差異;治療組與對(duì)照組治療后比較,除失眠、健忘、細(xì)脈外中醫(yī)證候積分均降低(P0.05),其中眩暈、腰酸、弦脈中醫(yī)證候積分降低極為顯著(P0.01),均具有統(tǒng)計(jì)學(xué)意義。結(jié)論:潛陽(yáng)育陰顆粒在西藥降壓達(dá)標(biāo)基礎(chǔ)上能改善陰虛陽(yáng)亢型高血壓患者的腎臟損害,同時(shí)進(jìn)一步改善中醫(yī)相關(guān)臨床癥狀,達(dá)到高質(zhì)量的降壓。
[Abstract]:Aim: to evaluate the effect of Qianyang Yuyin granule on early renal damage in patients with hypertension based on SPECT (amlodipine or combined with valsartan, systolic blood pressure (SBP) "f140mmHg and diastolic blood pressure (DBP)" f90mmHg). Methods: 60 inpatients with early renal damage of hypertension with syndrome of yin deficiency and yang hyperactivity were randomly divided into two groups with 30 patients in each group. The dosage of amlodipine 5 mg/d, was increased to 10 mg/d, when necessary. Or if necessary, valsartan was used to control blood pressure (systolic blood pressure (SBP) "f140mmmHg and diastolic blood pressure (DBP)" f90mmmHg). The treatment group was given Qianyang Yuyin granule 20 g, 2 / day, in the morning and evening. The control group was treated with other Chinese and Western drugs to protect renal function for 24 weeks. After treatment, the TCM syndrome, laboratory index, blood pressure and heart rate of the two groups were observed. The laboratory indexes were as follows: urine 尾 2 microglobulin (B2-mG), serum photostatin C (Cyst-C), urine N-acetyl尾-D-glucosidase (NAG) and SPECT. The glomerular filtration rate (GFR).) was measured by urine 尾 2 microglobulin (GFR).), serum photostatin C (GFR).), urine N-acetyl尾-D-glucosidase (GFR). After the treatment, the data were input into the SPSS program for analysis. Result: 1. The effect of Qianyang Yuyin granule on renal damage index: the renal damage index of each group in the treatment group was significantly improved after treatment (P 0.05), and the Cyst-C,B2-mG in the control group was significantly improved after treatment (P 0.05). There was no significant improvement in NAG,GFR in the control group (P0.05), and there was no significant difference between the treatment group and the control group (P0.05); the treatment group was significantly improved compared with the control group after treatment (P0.05). TCM syndrome curative effect: TCM syndrome total integral treatment group significantly decreased after treatment (P0.05), with statistical significance; control group after treatment significantly decreased (P0.05), with statistical significance; Compared with the control group, the treatment group improved significantly after treatment (P0.01), there was a significant difference between the treatment group and the control group. After treatment, the scores of TCM syndromes in the treatment group except forgetfulness were significantly decreased (P0.01), and there was a significant difference between the treatment group and the traditional Chinese medicine syndrome integral group (P < 0.01). In the control group, except knee soft, forgetfulness, tongue coating and veinlets, the scores of TCM syndrome were all decreased after treatment (P0.05), with statistical difference. After treatment, the scores of TCM syndromes in the treatment group were significantly lower than those in the control group (P 0.05), except insomnia, amnesia and veinlets (P 0.05), and the scores of vertigo, lumbar acid and string pulse were significantly lower than those in the control group (P 0.01). Conclusion: Qianyang Yuyin granule can improve the renal damage of hypertension patients with yin deficiency and yang hyperactivity on the basis of western medicine, and further improve the related clinical symptoms of traditional Chinese medicine, so as to achieve high quality hypotension.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

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