化痰祛瘀、健脾益肾法治疗高血压病早期肾脏损害的临床疗效观察及对肾血流的影响

发布时间：2018-02-26 13:47

本文关键词： 高血压病早期肾脏损害化痰祛瘀健脾益肾肾血流　出处：《黑龙江中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过对高血压病早期肾脏损害患者血压、尿微量白蛋白及肾脏叶间动脉的收缩期峰速度、舒张期末血流速度、阻力指数和中医证候积分的观察,探讨化痰祛瘀、健脾益肾法对高血压病早期肾脏损害的临床疗效及对肾血流的影响。方法:选取符合纳入标准的高血压病早期肾脏损害痰瘀互结型患者80例,将其随机分为对照组40例、治疗组40例。对照组给予常规药物治疗,治疗组在常规药物治疗基础上加用化痰祛瘀、健脾益肾方药。两组观察期限均为3周。观察两组患者治疗前后收缩压、舒张压、尿微量白蛋白及肾脏叶间动脉的收缩期峰速度、舒张期末血流速度、阻力指数的变化;同时观察两组患者治疗前后的中医证候积分。采用SPSS20.0软件进行统计分析比较。结果:1.治疗后中医证候积分组间比较,治疗组明显优于对照组,差异有统计学意义(p0.05)。治疗后治疗组中医证候总有效率为90%,明显优于对照组,组间比较差异有统计学义(p0.05)。2.两组治疗后收缩压、舒张压、尿微量白蛋白均较治疗前下降,差异有统计学意义(p0.05)。治疗后两组收缩压、舒张压、尿微量白蛋白组间比较,治疗组明显优于对照组,差异有统计学意义(p0.05)。3.治疗组治疗后肾脏叶间动脉的收缩期峰速度、舒张期末血流速度较治疗前明显加快,阻力指数较治疗前明显下降,差异有统计学意义(p0.05)。对照组收缩期峰速度、舒张期末血流速度较治疗前明显加快,阻力指数较治疗前明显下降,差异有统计学意义(p0.05)。治疗后收缩期峰速度、舒张期末血流速度、阻力指数组间比较,治疗组优于对照组,差异有统计学意义(p0.05)。结论:1.化痰祛瘀、健脾益肾法可改善高血压病早期肾脏损害患者的中医临床症状。2.化痰祛瘀、健脾益肾法可降低高血压病早期肾脏损害患者的血压及尿微量白蛋白水平。3.化痰祛瘀、健脾益肾法可增加高血压病早期肾脏损害患者肾脏叶间动脉的收缩期峰速度及舒张期末血流速度,降低阻力指数,对高血压导致的肾血流减少有改善作用。
[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.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R544.1

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