厄贝沙坦联合至灵菌丝胶囊对高血压病患者微量白蛋白尿作用的临床研究

发布时间：2018-08-15 12:01

【摘要】：目的:运用试纸法检测高血压病患者的尿微量白蛋白,探讨门诊就诊的高血压病患者微量白蛋白尿的阳性率,以及血管紧张素Ⅱ受体拮抗剂厄贝沙坦及中药至灵菌丝胶囊对微量白蛋白尿的影响。方法:纳入2015年12月～2017年2月在江苏省中医院心内科门诊及挹江门社区卫生服务中心全科门诊就诊的已诊断为高血压病的429名患者,运用研究用表收集相关研究信息,将纳入患者按性别及年龄分组,进行血压特点分析比较;采集就诊当时新鲜尿液,应用试纸法检测患者尿微量白蛋白及肌酐水平,统计微量白蛋白尿(MAU)阳性率;筛查出MAU阳性的患者,以血管紧张素Ⅱ受体拮抗剂(ARB)为基础降压药,连续治疗1月后复测研究指标,进行组内治疗前后MAU水平比较;MAU阳性患者随机分为ARB联合中药至灵菌丝胶囊组及非联合用药组,观察治疗后MAU转阴率。结果:1.男性患者的舒张压显著高于女性患者(p0.01);年龄越小,舒张压越高;收缩压组间无明显差异。2.429名高血压病患者MAU阳性总检出率为38.00%,男性患者尿微量白蛋白水平高于女性患者(P0.01)。3.ARB类药物治疗前后对比,治疗后尿微量白蛋白水平显著低于治疗前(P0.01)。4.ARB联合至灵菌丝胶囊治疗后,MAU阳性转阴率为69.77%,显著高于对照组41.46%(P0.01)。结论:1.高血压病患者MAU总检出率较高,男性患者、高龄者及青壮年患者的MAU阳性率较高,高血压病管理过程中,应重视对高龄患者及青壮年患者的MAU的检测。2.ARB类药物可以降低高血压病患者的MAU阳性率及MAU水平,具有一定的早期肾损害防治作用。3.中药至灵菌丝胶囊具有明显的MAU阳性的转阴作用,其作用机制值得进一步探讨。
[Abstract]:OBJECTIVE:To detect urinary microalbuminuria in patients with hypertension by test paper method,and to investigate the positive rate of microalbuminuria in outpatients with hypertension,and the effects of irbesartan,an angiotensin II receptor antagonist,and Zhiling mycelium Capsule on microalbuminuria.METHODS:The patients were enrolled in Jiangsu Province from December 2015 to February 2017. 429 patients diagnosed as hypertension in the outpatient department of Cardiology and the outpatient department of general health service center of Lijiang Men Community Health Service Center of Traditional Chinese Medicine Hospital were enrolled in this study. The positive rate of microalbuminuria (MAU) was calculated by measuring the levels of serum albumin and creatinine, and the patients with positive MAU were screened out. The patients with positive MAU were treated with angiotensin II receptor antagonist (ARB) as the basic antihypertensive drug for 1 month. The MAU levels were measured and compared before and after treatment. Results: 1. The diastolic blood pressure of male patients was significantly higher than that of female patients (p0.01); the diastolic blood pressure was higher with age; there was no significant difference between the systolic blood pressure groups. After ARB combined with Zhiling Mycelium Capsule, the positive rate of MAU was 69.77%, which was significantly higher than that of the control group (41.46%). Conclusion: 1. The total detection rate of MAU in hypertension patients was higher than that in male patients, elderly patients and young adults. In the process of hypertension management, attention should be paid to the detection of MAU in elderly patients and young adults. 2. ARB drugs can reduce the positive rate of MAU and the level of MAU in patients with hypertension, and have a certain role in the prevention and treatment of early renal damage. 3. Zhiling mycelium capsule has obvious negative effect of MAU, and its mechanism is worth further study. Discuss.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R544.1

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