摘要
目的探讨防己黄芪汤加味结合厄贝沙坦治疗高血压早期肾损伤(肺脾气虚证)的临床效果。方法队列研究。抽取2020年1月至2022年12月河南省中医院收治的高血压早期肾损伤(肺脾气虚证)患者102例,按随机数字表法分为西药组与结合中药组,每组51例。西药组采取厄贝沙坦治疗,结合中药组在此基础上联合防己黄芪汤加味治疗。比较两组临床疗效、中医证候积分、肾功能指标[肌酐清除率(CCR)、尿素氮(BUN)、血肌酐(SCr)、24 h尿微量白蛋白(24h-UmALB)、24 h尿蛋白定量(24h-UTP)]、肾动脉血流指标[肾椎体两侧叶间动脉收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、肾动脉阻力指数(RI)]及不良反应。结果结合中药组治疗总有效率(96.08%,49/51)高于西药组(84.31%,43/51),P<0.05。治疗后,结合中药组各项中医证候积分均低于西药组(P均<0.05)。治疗后,结合中药组CCR高于西药组,BUN、SCr、24h-UmALB及24h-UTP水平低于西药组(P<0.05)。治疗后,结合中药组肾椎体两侧叶间动脉PSV、EDV均快于西药组,RI低于西药组(P<0.05)。两组不良反应发生率比较差异未见统计学意义(P>0.05)。结论防己黄芪汤加味联合厄贝沙坦治疗高血压早期肾损伤(肺脾气虚证)的临床效果较好,可改善患者症状及肾功能,且不良反应少。
ObjectiveTo investigate the clinical effect of modified Fangji Huangqi decoction combined with irbesartan in the treatment of early renal injury in hypertension with lung-spleen Qi deficiency syndrome.MethodsA total of 102 patients with early renal injury in hypertension with lung-spleen Qi deficiency syndrome who were admitted to Henan Provincial Hospital of Traditional Chinese Medicine from January 2020 to December 2022 were selected for the cohort study,and they were divided into the western medicine group and the combined Chinese medicine group according to the random number table method,with 51 cases in each group.The western medicine group was treated with irbesartan,and the Chinese medicine group was treated with modified Fangji Huangqi decoction based on the treatment of the western medicine group.The clinical efficacy,traditional chinese medicine symptom scores,renal function indexes including creatinine clearance rate(CCR),urea nitrogen(BUN),serum creatinine(SCr),24 h urinary microalbumin(24h-UmALB)and 24 h urinary protein quantification(24h-UTP),renal artery blood flow indexes including peak systolic velocity(PSV),end diastolic velocity(EDV)and renal artery resistance index(RI),and adverse reactions were compared between the two groups.ResultsThe total effective rate of the combined Chinese medicine group(96.08%,49/51)was higher than that of the western medicine group(84.31%,43/51),P<0.05.After treatment,the scores of traditional chinese medicine symptoms in the combined Chinese medicine group were lower than those in the western medicine group(all P<0.05).After treatment,the CCR of the combined Chinese medicine group was higher than that of the western medicine group,while the levels of BUN,SCr,24h-UmALB and 24h-UTP were lower than those of the western medicine group(P<0.05).After treatment,the PSV and EDV of interlobar artery on both sides of renal vertebral body in the combined Chinese medicine group were faster than those in the western medicine group,while RI was lower than that in the western medicine group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).ConclusionsThe clinical effect of modified Fangji Huangqi decoction combined with irbesartan in the treatment of early renal injury in hypertension with lung-spleen Qi deficiency syndrome is better,which can improve the symptoms and renal function of patients,with less adverse reactions.
作者
李东洋
陈小永
庞欣欣
高雅婵
张鸽
Li Dongyang;Chen Xiaoyong;Pang Xinxin;Gao yachan;Zhang Ge(Department of Nephrology,Henan Provincial Hospital of Traditional Chinese Medicine,Zhengzhou 450000,China;Department of Anorectal,Henan Provincial Hospital of Traditional Chinese Medicine,Zhengzhou 450000,China)
出处
《中国实用医刊》
2025年第9期111-114,共4页
Chinese Journal of Practical Medicine
基金
河南省中医药科学研究专项课题(2022JDX139)。
关键词
厄贝沙坦
高血压早期肾损伤
肺脾气虚证
防己黄芪汤加味
肾功能
Irbesartan
Hypertensive early renal injury
Lung and spleen Qi deficiency syndrome
Modified Fangji Huangqi decoction
Renal function
