连黄降浊汤治疗高血压肾损害（肾功能衰竭期）的临床视察.pdfVIP

提 要 目的：观察连黄降浊汤对高血压性肾损害（肾功能衰竭期）病程的影响并探讨其 作用机制。方法：60例中医辨证符合脾肾两虚、浊瘀阻滞型的高血压肾损害（肾功能 衰竭期）患者，根据就诊先后顺序随机分为实验组和对照组各30例，在一般治疗的基 础上，实验组予连黄降浊汤200ml 日二次口服，对照组予尿毒清颗粒（每次一包，每 日3次），观察、治疗时间≥12个月,观察两组患者的血压、24h尿蛋白定量、血红蛋白、 血肌酐、PTH 的变化，通过血肌酐倒数(1 ／Scr)和时间的回归系数分析及回归直线分 析，根据斜率b值的走向，观察肾功能损害的发展趋势；并分析高血压、蛋白尿、血 红蛋白、PTH对b值的影响。结果：观察治疗结束后，实验组b值-5.79×10-4对照组b值 为-8.64×10-4实验组斜率明显小于对照组（P0.01 ），表明连黄降浊汤较尿毒清颗粒能 更好地延缓CRF病程；通过观察高血压、尿蛋白、血红蛋白、 PTH对CRF病程的影 响，发现上述因素可加速CRF病程，中药干预可延缓上述因素对CRF病程的影响，而 连黄降浊汤优于尿毒清颗粒（P0.05 ）。结论：祛湿降浊佐以健脾补肾、活血通络法 （连黄降浊汤）通过减缓高血压、尿蛋白、贫血钙磷代谢紊乱等对CRF 的影响，延 缓CRF病程。 关键词 高血压性肾损害；湿浊内蕴证；连黄降浊汤； 祛湿降浊；病程 A Clinical Study on the Treating Renal Damage due toPrimary Hypertension with Lianhuang Turbid decoction Specialty：Internal Medicine of Chinese traditional medicine Author ：Liu Meihui Tutor：Professor Guo Zhaoan Abstract Objective:. To study the effect of Lianhuang Turbid decoction on renal structure and explore its mechanism. Methods: 60patients with RDHRFS were divided randomly into two groups with theratio of 1 ∶1,the experiment group and the control group.Patients. In the experiment group(30cases),patients were administered orally with LHCTG,while those in the control group(30cases) were treated with Uremic Clearance Granules(UCG). Besides the general treatment, LianHangJiangZhuo decoction is given to experimental group (1 package once, 2 times daily) and Niao Du Qing Granule for control group with a treatment of at least 12 months. Patients in both groups are observed with blood pressure, 24-hours urinary protein, hemoglobin and serum creatinine changes, observe their renal dysfunction development trends by analyzing the countdown through the serum creatinine (1/Scr) and time of regression coefficient and linear regression and the direction of slope b value