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目的:探讨参芪地黄汤加减联合西药治疗高血压肾病的疗效。方法:根据随机数字表法将2012年1月—2016年7月本院收治的180例高血压肾病患者分为对照组(90例)与观察组(90例),对照组患者接受硝苯地平联合卡托普利治疗,观察组患者在硝苯地平、卡托普利基础上再联合使用参芪地黄汤,现对比分析两组患者的治疗效果。结果:(1)组内不同时间点之间的血压比较:治疗前、治疗1个月后、治疗3个月后,观察组与对照组3个时间点之间的舒张压(DBP)、收缩压(SBP)比较差异均有统计学意义(P<0.05),治疗前的DBP、SBP均显著高于治疗1个月后、治疗3个月后(P<0.05),治疗1个月后的DBP、SBP均显著高于治疗3个月后(P<0.05)。(2)组内不同时间点之间的肾功能指标比较:治疗前、治疗1个月后、治疗3个月后,观察组与对照组3个时间点之间的血清胱抑素C(SCys C)、估算肾小球滤过率(eGFR)、尿微量白蛋白(Um Alb)相比差异均有统计学意义(P<0.05);治疗前的SCys C、Um Alb显著高于治疗1个月后、治疗3个月后(P<0.05),eGFR显著低于治疗1个月后、治疗3个月后(P<0.05);治疗1个月后的SCys C、Um Alb显著高于治疗3个月后(P<0.05),eGFR显著低于治疗3个月后(P<0.05)。不同时间点两组之间肾功能指标比较:治疗前,两组患者SCys C、eGFR、Um Alb相比差异均无统计学意义(P>0.05);治疗1个月后、治疗3个月后,观察组SCys C、Um Alb显著低于对照组,eGFR均显著高于对照组,差异均有统计学意义(P<0.05)。结论:参芪地黄汤加减联合西药治疗高血压肾病的疗效确切,在控制血压的同时有效保护患者肾功能,值得临床推广应用。
Objective: To investigate the curative effect of Shenqi Dihuang Decoction combined with western medicine on hypertensive nephropathy. Methods: According to the random number table method, 180 cases of hypertensive nephropathy admitted to our hospital from January 2012 to July 2016 were divided into control group (90 cases) and observation group (90 cases). Patients in the control group received nifedipine Combined with captopril treatment, the observation group of patients in the nifedipine, captopril and then combined with Shenqi Di Huang Tang, are compared analysis of the treatment effect of two groups of patients. Results: (1) Comparison of blood pressure at different time points: before treatment, after 1 month of treatment, after 3 months of treatment, the diastolic blood pressure (DBP) and contractions between the observation group and the control group at 3 time points (P <0.05). The DBP and SBP before treatment were significantly higher than those after 1 month of treatment and after 3 months of treatment (P <0.05). After 1 month of treatment DBP, SBP were significantly higher than 3 months after treatment (P <0.05). (2) The comparison of renal function indexes between different time points before treatment: 1 month after treatment, 3 months after treatment, the levels of serum cystatin C (SCs) in observation group and control group at 3 time points C, estimated glomerular filtration rate (eGFR), urine microalbumin (Um Alb) were significantly different (P <0.05); before treatment of SCys C, Um Alb was significantly higher than the treatment of a After 3 months of treatment (P <0.05), eGFR was significantly lower than that of 1 month after treatment and after 3 months of treatment (P <0.05); SCys C and Um Alb after 1 month of treatment were significantly higher than those of treatment After 3 months (P <0.05), eGFR was significantly lower than 3 months after treatment (P <0.05). There was no significant difference of SCys C, eGFR and Um Alb between the two groups before treatment (P> 0.05). After 1 month of treatment, after 3 months of treatment , And the scores of SCys C and Um Alb in the observation group were significantly lower than those in the control group, and the eGFR values in the observation group were significantly higher than those in the control group (P <0.05). Conclusion: Shenqidihuang decoction combined with Western medicine in the treatment of hypertensive nephropathy is effective in controlling blood pressure while effectively protecting the renal function of patients, worthy of clinical application.