CAJ | 학술논문

目的:观察益肾平肝方(熟地、杜仲、桑寄生、钩藤、罗布麻、葛根和川牛膝)对高血压早期肾损害病人动态血压、肾功能及血管内皮功能的影响.方法:收集高血压早期肾损害患者90例,随机分为3组,中药组(益肾平肝方),中西药结合组(益肾平肝方+贝那普利),西药组(贝那普利),用药3个月,观测治疗前后的24h动态血压、尿微量白蛋白(mALB)、尿β_2-微球蛋白(β_2-MG)、血清内皮素(ET)及-氧化氮(NO)的变化.结果:中药组治疗后动态血压各指标与治疗前比较均有显著下降(P<0.01～0.05),3组组间比较无显著差异;中药组能明显降低尿mALB及β_2-MG水平(P<0.01),且略优于西药组;治疗后ET、NO两指标中药组治疗前后比较有显著差异性(P<0.01),中药组、中西药结合组与西药组组间比较差异显著(P<0.01).结论:益肾平肝方可有效降低原发性高血压早期肾损害患者的白昼和夜间血压,并在一定程度上可改善和逆转异常的血压昼夜节律;能明显降低患者的微量蛋白尿,该药的降压及肾保护作用可能是通过影响血管内皮功能实现的.
목적:관찰익신평간방(숙지、두중、상기생、구등、라포마、갈근화천우슬)대고혈압조기신손해병인동태혈압、신공능급혈관내피공능적영향.방법:수집고혈압조기신손해환자90례,수궤분위3조,중약조(익신평간방),중서약결합조(익신평간방+패나보리),서약조(패나보리),용약3개월,관측치료전후적24h동태혈압、뇨미량백단백(mALB)、뇨β_2-미구단백(β_2-MG)、혈청내피소(ET)급-양화담(NO)적변화.결과:중약조치료후동태혈압각지표여치료전비교균유현저하강(P<0.01～0.05),3조조간비교무현저차이;중약조능명현강저뇨mALB급β_2-MG수평(P<0.01),차략우우서약조;치료후ET、NO량지표중약조치료전후비교유현저차이성(P<0.01),중약조、중서약결합조여서약조조간비교차이현저(P<0.01).결론:익신평간방가유효강저원발성고혈압조기신손해환자적백주화야간혈압,병재일정정도상가개선화역전이상적혈압주야절률;능명현강저환자적미량단백뇨,해약적강압급신보호작용가능시통과영향혈관내피공능실현적.
AIM:To observe the effects of Yishen Pinggan Decoction(Cortex eucommiae,Herba taxilli,Ramulus uncariae cum uncis,Folium apocyni veneti,Radix puerariae lobatae,Radix cyathulae)on ambulatory blood pressure,renal function and vascular endothelial function of hypertensive patients with early renal damage.METHODS:Ninety hypertensive patients with early renal damage were randomly assigned into 3 groups.the Chinese medicine group(Yishen Pinggan Decoction),combining Chinese medicine with chemical medicine group (Yishen Pinggan Decoction+Benazepril),chemical medicine group(Benazepril),taking medicine for three months,observed before and after treatment of 24 h ambulatory blood pressure,urinary albumin(mALB),urinary β_2-microglobulin(β_2-MG),serum endothelin(ET)and nitric oxide(NO)to evaluate changes.RESULTS:After treatment,each indicators of ambulatory blood pressure of the Chinese medicine group decreased significantly by comparison with those before treatment(P<0.01-0.05);There were no significant differences among the three groups,mALB and urine β_2-MG levels of Chinese medicine group decreased significantly(P<0.01),and slightly better than that of chemical medicine group;before and after treatment,ET,NO two indicators of Chinese medicine group were significantly different(P<0.01),there were significant differences among the three groups of intergroup comparison;(P<0.01).CONCLUSION:Yishen Pinggan Decoction could be effective in hypertensive patients with early renal damage to reduce the daytime and nighttime blood pressure,and to some extent to improve and reverse the abnormal circadian rhythm of blood pressure;the decoction could significantly reduce mieroalbuminutia in patients,autihypertensive and renal function protection of the decoction may contribute to the improvement in VasCUlar endothelial function.