桑芪首乌膏方治疗高血压早期肾损害的临床研究

发布时间：2018-06-06 11:04

本文选题：桑芪首乌膏方 + 高血压早期肾损害　；参考：《云南中医学院》2017年硕士论文

【摘要】：目的:通过观察桑芪首乌膏方对高血压早期肾损害患者的中医临床证候、血压、尿微量白蛋白、尿β2-微球蛋白的影响,以明确桑芪首乌膏方治疗高血压早期肾损害的临床有效性、安全性,为桑芪首乌膏方防治高血压早期肾损害提供临床依据。方法:选择72例现代医学诊断符合高血压早期肾损害[1],中医证候符合云南省荣誉名老中医陆家龙教授使用桑芪首乌膏方纳入标准的患者,按照随机、双盲原则分为治疗组和对照组。两组均予常规降压治疗(基础治疗和西药治疗)以维持血压平稳于正常,治疗组同时加服桑芪首乌膏方(每日两次,每次1袋,每次餐后半小时,加开水100ml搅匀后温服),对照组同时加服桑芪首乌膏方模拟方(用法同上)对照,疗程均为28天。观察、分析治疗前后两组的中医症状积分、血压(空腹、9点抽血前)、尿微量白蛋白(m Alb)、尿β2-微球蛋白(β2-MG)、安全性观察指标(WBC、RBC、HB、PC、ALT、AST、ALP、Cr、BUN)的变化。结果:两组患者治疗前性别、年龄、病程、症状总积分、各单项症状积分、血压、尿微量白蛋白、β2-微球蛋白等一般情况比较,无统计差异(P0.05)。治疗后治疗组总有效率为97.15%,优于对照组的61.11%,两组间比较有统计差异(P0.05)。治疗组治疗后症状总积分与治疗前比较,有显著统计差异(P0.01);对照组治疗后症状总积分与治疗前比较,有统计差异(P0.05);两组治疗后症状总积分组间比较,有统计差异(P0.05)。治疗组治疗前后自身比较,眩晕、夜尿频多、腰酸、膝软、耳鸣、心悸、口干、口苦、失眠、便秘症状改善有显著统计差异(P0.01),气短、纳差症状改善有统计差异(P0.05);对照组治疗前后自身比较,眩晕、纳差症状改善有显著统计差异(P0.01),腰酸、心悸、口干、口苦症状改善有统计差异(P0.05);治疗后两组间比较,夜尿频多、腰酸、膝软、纳差、失眠症状改善有显著统计差异(P0.01),口苦、便秘症状改善有统计差异(P0.05)。两组治疗后收缩压、舒张压与治疗前比较均无统计差异(P0.05);两组治疗后收缩压、舒张压组间比较无统计差异(P0.05)。治疗组治疗后尿微量白蛋白、尿β2-微球蛋白与治疗前比较,有显著统计差异(P0.01);对照组治疗后尿微量白蛋白、尿β2-微球蛋白与治疗前比较,无统计差异(P0.05);两组治疗后尿微量白蛋白组间比较有显著统计差异(P0.01),尿β2-微球蛋白组间比较有统计差异(P0.05)。治疗后血常规、肝肾功能(WBC、RBC、HB、PC、ALT、AST、ALP、Cr、BUN)等各项指标与治疗前比较,无统计差异(P0.05)。结论:桑芪首乌膏方在西药控制血压的基础上,不仅可以改善高血压早期肾损害相关临床症状,对高血压尿微量白蛋白、尿β2-微球蛋白等肾脏早期损害相关指标的改善作用也是明显的。提示桑芪首乌膏方对延缓、逆转高血压早期肾损害的进展具有积极的意义,为进一步院内制剂的研发提供了临床依据。未见不良反应,值得进一步深入研究并推广。同时本研究对继承名老中医学术思想和经验方的传承发展方面具有重要意义。
[Abstract]:Objective: To investigate the clinical efficacy and safety of Sanqi Shouwu ointment prescription in the treatment of early renal damage of hypertension by observing the effect of Sanqi Shouwu ointment on the clinical syndromes, blood pressure, microalbuminuria and urinary beta 2- microglobulin in patients with early renal damage. Methods: 72 cases of modern medical diagnosis were selected to meet the early renal damage [1] of hypertension. The TCM syndromes were in accordance with the honorary old traditional Chinese medicine Lu Jialong of Yunnan province. The patients were divided into the treatment group and the control group according to the random, double blindness principle. The two groups were treated with routine antihypertensive treatment (basic treatment and Western Medicine). At the same time, the blood pressure was normal. The treatment group took Sanqi first Polygonum multiflorum (two times a day, 1 bags each time, half an hour after the meal, adding 100ml to stir up the warm clothes). The control group also took Sanqi Shouwu ointment recipe (with the same above) for 28 days. Observation, analysis of the two groups of TCM symptoms scores, blood pressure (empty stomach, 9) M Alb, urinary beta 2- microglobulin (beta 2-MG), safety observation index (WBC, RBC, HB, PC, ALT, AST, ALP, Cr, Cr). Results: there was no statistical difference between the two groups of patients before treatment, such as sex, age, course of disease, total score of symptoms, symptom integral, blood pressure, microalbumin, beta microglobulin, etc. (P0.05) after treatment, the total effective rate of the treatment group was 97.15%, superior to 61.11% in the control group, and there was a statistical difference between the two groups (P0.05). The total score of the treatment group was compared with that before treatment (P0.01); the total score of the control group after treatment was compared with that before treatment (P0.05); the total score of the symptom after treatment was the total score of the treatment group. There were statistical differences (P0.05). The treatment group was compared before and after treatment, vertigo, night urine frequency, waist acid, knee soft, tinnitus, palpitation, mouth dry, pain, insomnia, and constipation symptoms improved significantly (P0.01), shortness of breath, and the improvement of the symptoms of difference (P0.05); the control group was compared before and after the treatment, dizziness, and the symptoms of differential symptoms improved significantly. Statistical difference (P0.01), lumbar acid, palpitation, dry mouth, pain symptoms improved statistical difference (P0.05); after treatment, the two groups, night urine frequency, waist acid, knee soft, Na difference, insomnia improvement has significant statistical difference (P0.01), oral pain, constipation symptoms improved statistical difference (P0.05). The two groups after treatment systolic pressure, diastolic pressure, and diastolic pressure were no more than before treatment Statistical difference (P0.05); there was no statistical difference between the two groups after treatment, and there was no statistical difference between the treatment group and the diastolic pressure group (P0.05). There were significant statistical differences (P0.01) in the urine microalbumin and urine beta 2- microglobulin in the treatment group after treatment. There was no statistical difference between the control group after treatment and the comparison between the urine beta 2- microglobulin and the pre treatment group (P0.05); There were significant statistical differences (P0.01) among the urine microalbumin groups after treatment (P0.05). After treatment, the indexes of blood routine, liver and kidney function (WBC, RBC, HB, PC, ALT, AST, ALP, Cr, BUN) were compared with those before treatment. Conclusion: Sanqi Shouwu cream is the basis for controlling blood pressure in western medicine. On the other hand, it can not only improve the clinical symptoms related to early renal damage in hypertension, but also improve the early renal damage related indexes, such as microalbuminuria and urinary beta 2- microglobulin, which suggests that Sanqi first Polygonum multiflorum has a positive significance for the delay and reverses the early renal damage in hypertension. There is no adverse reaction, it is worth further research and promotion. Meanwhile, this study is of great significance to inheriting the inheritance and development of the academic thought and experience of the old traditional Chinese medicine.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

【参考文献】