金匮肾气汤加减治疗肾性高血压脾肾阳虚证的临床观察

梁颖兰; 张琼

doi:10.13422/j.cnki.syfjx.20192033

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金匮肾气汤加减治疗肾性高血压脾肾阳虚证的临床观察

临床 | 更新时间：2021-02-09

- 金匮肾气汤加减治疗肾性高血压脾肾阳虚证的临床观察
- Clinical Efficacy of Modified Jingui Shenqitang in Treatment of Renal Hypertension with Spleen-kidney Yang Deficiency Syndrome
- 中国实验方剂学杂志 2020年26卷第5期页码：81-86
- 作者机构：
  
  西南医科大学　附属中医医院，四川泸州　 646000
- 作者简介：
  
  [第一作者]　梁颖兰，主治医师，从事中西医结合治疗肾病的临床工作，E-mail：710461809@qq.com
  *张琼，博士，主任中医师，从事中西医结合治疗肾病的临床工作，E-mail：lyjean69@163.com
- 基金信息：
  
  四川省中医药管理局科研项目(2018JC031)
- DOI：10.13422/j.cnki.syfjx.20192033
  中图分类号： R289; R54; R541; R544.1
- 收稿日期：2019-05-17，
  
  网络出版日期：2019-06-28，
  
  纸质出版日期：2020-03-05
- 稿件说明：
移动端阅览
梁颖兰, 张琼. 金匮肾气汤加减治疗肾性高血压脾肾阳虚证的临床观察[J]. 中国实验方剂学杂志, 2020,26(5):81-86.

Ying-lan LIANG, Qiong ZHANG. Clinical Efficacy of Modified Jingui Shenqitang in Treatment of Renal Hypertension with Spleen-kidney Yang Deficiency Syndrome[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(5): 81-86.
梁颖兰, 张琼. 金匮肾气汤加减治疗肾性高血压脾肾阳虚证的临床观察[J]. 中国实验方剂学杂志, 2020,26(5):81-86. DOI： 10.13422/j.cnki.syfjx.20192033.

Ying-lan LIANG, Qiong ZHANG. Clinical Efficacy of Modified Jingui Shenqitang in Treatment of Renal Hypertension with Spleen-kidney Yang Deficiency Syndrome[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(5): 81-86. DOI： 10.13422/j.cnki.syfjx.20192033.

摘要

目的：

探讨金匮肾气汤加减治疗肾性高血压脾肾阳虚证的疗效及对血脂、肾功能和血管内皮功能的影响。

方法：

随机按数字表法将110例患者分为对照组与观察组各55例。对照组口服左旋氨氯地平片，2.5～5 mg/次，1次/d；和马来酸依那普利，10 mg/次，1次/d。观察组在对照组治疗的基础上给予金匮肾气汤加减，1剂/d。两组疗程均为连续治疗12周。进行血压监测，比较治疗前后两组收缩压(SBP)和舒张压(DBP)水平，并计算血压的达标情况；检测治疗前后24 h尿蛋白定量(24 hUpr)，血肌酐(SCr)，白蛋白(ALB)，尿素氮(BUN)，计算肾小球滤过率(eGFR)，检测治疗前后甘油三酯(TG)，总胆固醇(TC)，高密度脂蛋白胆固醇(HLD-C)和低密度脂蛋白胆固醇(LDL-C)水平；进行治疗前后脾肾阳虚证症状评分；检测治疗前后一氧化氮(NO)，血浆内皮素(ET)，血管紧张素Ⅱ(Ang Ⅱ)水平。

结果：

观察组血压疗效优于对照组(

＝1.905，

0.05)；观察组中医证候疗效优于对照组(

＝2.416，

0.01)；观察组偶测血压达标率为88.89%，高于对照组的71.25%(

＝7.861，

0.01)；观察组SBP和DBP水平均低于对照组(

0.05)；观察组患者TC和LDL-C水平较对照组降低(

0.01)；观察组患者24 hUpr，BUN和SCr均低于对照组(

0.05)，eGFR高于对照组(

0.05)；观察组患者ET-1，Ang Ⅱ水平均低于对照组(

0.01)，NO水平高于对照组(

0.01)。

结论：

在西医常规干预的基础上，金匮肾气汤加减治疗肾性高血压脾肾阳虚证患者可进一步的控制血压水平，提高血压的达标率，并具有调节脂代谢和保护肾功能的作用，还有调节血管内皮功能的效应，临床疗效优于单纯的西医治疗。

Abstract

Objective:

To explore the efficacy of modified Jingui Shenqitang in the treatment of renal hypertension with spleen-kidney yang deficiency syndrome and its effect on blood lipids

renal function and vascular endothelial function.

Method:

Totally 110 patients were randomly divided into control group and observation group by random number table method

with 55 cases in each group. Control group was given levamlodipine (2.5-5 mg every time

once/day) and enalapril maleate (10 mg every time

once/day)

and observation group was given modified Jingui Shenqitang in addition to the therapy of control group (1 dose/day). They were treated for 12 weeks. Blood pressure monitoring was performed

the systolic blood pressure (SBD) and diastolic blood pressure (DBP) were compared before and after treatment

and the blood pressure compliance was calculated. The 24 h urinary protein quantification (24 hUpr)

serum creatinine (SCr)

albumin (ALB) and urea nitrogen (BUN) were detected before and after treatment

the glomerular filtration rate (eGFR) was calculated

and the triglyceride (TG)

total cholesterol (TC)

high-density lipoprotein cholesterol (HLD-C) and low-density lipoprotein( LDL-C) were detected before and after treatment. The spleen-kidney Yang deficiency syndromes were scored before and after treatment. The levels of nitric oxide (NO)

plasma endothelin (ET) and angiotensin Ⅱ (Ang Ⅱ) were detected before and after treatment.

Result:

The blood pressure efficacy in observation group was better than that in control group (

=1.905

0.05). The efficacy of traditional Chinese medicine(TCM) syndromes in observation group was better than that in control group (

=2.416

0.01). The compliance rate of causal blood pressure in observation group was higher than that in control group (88.89% vs 71.25%) (

=7.861

0.01). SBP and DBP in observation group were lower than those in control group (

0.05). TC and LDL-C in observation group were lower than those in control group (

0.01). The 24 hUpr

BUN and SCr in observation group were lower than those in control group (

0.05)

while the eGFR was higher than that in control group (

0.05). The levels of ET-1 and Ang Ⅱ in observation group were lower than those in control group (

0.05)

whereas the NO level was higher than that in control group (

0.01).

Conclusion:

In addition to the routine intervention with western medicine

modified Jingui Shenqitang for patients with spleen-kidney Yang deficiency syndrome can further control blood pressure level

improve blood pressure compliance rate

regulate lipid metabolism

protect kidney function

and regulate vascular endothelial function

with a better clinical efficacy than pure western medicine.

关键词

Keywords

references

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