摘要
目的观察苓桂术甘汤加味治疗高血压早期肾损害痰湿壅盛证的临床效果。方法入选痰湿壅盛型高血压早期肾损害患者83例,采用随机数字表法,将患者分为观察组(41例)和对照组(42例)。对照组给予氨氯地平治疗,观察组在对照组基础上予以苓桂术甘汤加味治疗。比较两组治疗前后血压[收缩压(SBP)、舒张压(DBP)]水平、24 h动态血压[24 h SBP、24 h DBP、收缩压变异性(SBPV)、舒张压变异性(DBPV)]水平,早期肾损害指标[血清胱抑素C(Cys-C)、尿微量白蛋白(UmALB)、超敏C反应蛋白(hs-CRP)]、中医证候积分以及中医证候疗效、安全性。结果治疗前两组SBP、DBP比较,差异无统计学意义(P>0.05);治疗后,两组SBP、DBP均较治疗前有所改善,且观察组SBP(132.84±5.79)mm Hg(1 mm Hg=0.133 kPa)、DBP(81.68±4.13)mm Hg低于对照组的(139.98±5.19)、(87.72±4.95)mm Hg(P<0.05)。治疗前两组24 h SBP、24 h DBP、SBPV、DBPV比较,差异无统计学意义(P>0.05);治疗后两组24 h SBP、24 h DBP、SBPV、DBPV均较治疗前有所改善,且观察组降低程度均优于对照组(P<0.05)。两组治疗后UmALB、Cys-C、hs-CRP均较治疗前降低,且观察组UmALB(42.73±2.18)mg/L、Cys-C(1.56±0.87)mg/L、hs-CRP(1.30±0.73)mg/L低于对照组的(53.52±3.69)、(2.60±0.73)、(2.75±1.56)mg/L(P<0.05)。观察组总有效率(95.12%)高于对照组(80.95%)(P<0.05)。两组治疗后的中医证候(眩晕、头痛、胸闷)积分均较治疗前降低,且观察组眩晕积分(1.75±1.13)分、头痛积分(1.56±0.64)分、胸闷积分(1.60±0.70)分比对照组的(2.52±0.80)、(2.11±0.70)、(2.04±0.69)分更低(P<0.05)。观察组1例出现头胀,对照组1例出现恶心、纳差,两者程度均轻微,次日缓解,可能与早期氨氯地平口服有关。两组患者均未发生严重不良反应。结论苓桂术甘汤加味可以有效降低高血压早期肾损害痰湿壅盛证患者的血压,减少早期肾损害,改善患者临床症状,减少不良反应。
Objective To observe the clinical effect of modified Linggui Zhugan Decoction for patients with early hypertensive renal damage(phlegm dampness stagnation syndrome).Methods According to a random number table,83 patients with early hypertensive renal damage(phlegm dampness stagnation syndrome)were selected and divided into an observation group(41 cases)and a control group(42 cases).The control group was treated with amlodipine,while the observation group was treated with modified Linggui Zhugan decoction on the basis of the control group.Comparison of blood pressure[systolic blood pressure(SBP),diastolic blood pressure(DBP)],24-h dynamic blood pressure[24 h SBP,24 h DBP,systolic blood pressure variability(SBPV),diastolic blood pressure variability(DBPV)],early renal damage indicators[serum cystatin C(Cys-C),urinary microalbumin(UmALB),high sensitivity C-reactive protein(hs-CRP)],traditional Chinese medicine syndrome score,and efficacy and safety between the two groups.Results Before treatment,there was no statistically significant difference in SBP and DBP between the two groups(P>0.05).After treatment,SBP and DBP in both groups improved compared with before treatment;the observation group had SBP of(132.84±5.79)mm Hg(1 mm Hg=0.133 kPa)and DBP of(81.68±4.13)mm Hg,which were lower than those in the control group[(139.98±5.19)and(87.72±4.95)mm Hg](P<0.05).Before treatment,there was no statistically significant difference in 24-h SBP,24-h DBP,SBPV and DBPV between the two groups(P>0.05).After treatment,the 24-h SBP,24-h DBP,SBPV and DBPV in both groups were improved compared with before treatment;the reduction in the observation group was better than that in the control group(P<0.05).After treatment,UmALB,Cys-C and hs-CRP in both groups were all lower than those before treatment;the observation group had UmALB of(42.73±2.18)mg/L,Cys-C of(1.56±0.87)mg/L,and hs-CRP of(1.30±0.73)mg/L,which were lower than those in the control group[(53.52±3.69),(2.60±0.73),and(2.75±1.56)mg/L](P<0.05).The total effective rate of the observation group(95.12%)was higher than that of the control group(80.95%)(P<0.05).After treatment,the scores of traditional Chinese medicine syndromes(dizziness,headache,chest tightness)in both groups were lower than those before treatment;the vertigo score in the observation group was(1.75±1.13)points,the headache score was(1.56±0.64)points,and the chest tightness score was(1.60±0.70)points,which were lower than those in the control group[(2.52±0.80),(2.11±0.70),and(2.04±0.69)points](P<0.05).1 case in the observation group experienced headache,and 1 case in the control group experienced nausea and loss of appetite.Both cases were mild and resolved the next day,possibly related to early oral administration of amlodipine.No serious adverse reactions occurred in either group.Conclusion The modified Linggui Zhugan Decoction can effectively lower blood pressure,reduce early renal damage in patients with early hypertensive renal damage(phlegm dampness stagnation syndrome),improve clinical symptoms,and reduce adverse reactions in patients.
作者
邹静
章霞
郑梅生
ZOU Jing;ZHANG Xia;ZHENG Mei-sheng(Wuhu Traditional Chinese Medicine Hospital,Wuhu 241000,China)
出处
《中国现代药物应用》
2025年第17期11-15,共5页
Chinese Journal of Modern Drug Application
基金
安徽省教育厅2021年度高校自然科学研究项目(项目编号:KJ2021A1277)。
关键词
苓桂术甘汤加味
高血压
早期肾损害
痰湿壅盛证
Modified Linggui Zhugan Decoction
Hypertension
Early renal damage
Phlegm dampness stagnation syndrome
