黄芪对高血压病合并代谢综合征患者早期心肾保护的临床研究.docVIP

黄艮对高血压病合并代谢综合征患者早期心肾保护的 临床研究 ［摘要］探?黄罠对高血压病（EII）合并代谢综合征（MetS）患者的早 期心肾保护作用。将226例18岁以上的EH合并MetS且无明显靶器官受 损临床表现的患者，随机分配至对照组、黄罠1组和黄罠2组。对照组使 用常规内科药物治疗，在此基础上黄罠1组加用黄罠浸膏胶囊10 g?d-l, 黄罠2组加用黄罠浸膏胶囊5 g?d-lo应用彩色超声心动仪，经M型、二 维及组织多普勒测定等方法评价心脏解剖结构、收缩功能及心脏舒张功 能；采用放射免疫分析法评价尿微量白蛋白（MAU）,同时计算估测肾小球 滤过率（cGFR），随访12个月。研究方案经医院伦理委员会通过，并向中 国临床试验注册中心网站注册，所有患者均行知情同意。运用SPSS软件 对数据进行统计学分析。结果显示，3组患者的代谢指标治疗前后及组间 疗效无明显的差异；3组患者的收缩末期容量（ESV）及左心室收缩末期内 径（LVESd）治疗后均较治疗前改善，但3组间无显著差异；加用黄罠治 疗后患者的二尖瓣血流速度（Vp）得到了一定的改善（P〈0.05）,但3组 间无显著差异；黄罠对降低MAU有显著作用（P〈0.05）,且黄罠1组较对 照组和黄罠2组下降更为显著（P0. 05）o黄罠联合内科常规治疗与单纯 内科常规治疗相比，有改善EII合并MetS患者心脏结构及收缩舒张功能， 并减少MAU水平的趋势，且高剂量黄罠的心肾早期保护作用优于低剂量黄 罠。但尚需长时间治疗疗效的观察，以进一步证实黄罠对EH合并血tS患 者的疗效。 [关键词]黄罠；高血压病；代谢综合征；心脏舒张功能；尿微量 白蛋白 [Abstract]To explore the effect of Mongolia Astragali Radix produced in Longxi of Gansu province in protecting cardiac and nephritic functions of patients of essential hypertension (EH) with metabolic syndrome (MetS) ? A total of two hundred and twenty-six EH patients with MetS aged above 18 were selected? Patients were randomly divided to control group (adopted conventional medical treatment), Astragali Radix group 1 (added Astragali Radix capsules 10 g?d~l besides conventional medical treatment) and Astragali Radix group 2 (added Astragali Radix capsules 5 g?d~l besides conventional medical treatment )? Cardiac anatomy structure, cardiac systolic function and diastolic function were measured by M-mode echocardiography , two-dimensional echocardiography , Doppler echocardiographic determination and tissue Doppler imaging. The level of microalbum in uria ( MAU ) was evaluated by radioimmunoassay. In addition, the estimated glomerular filtration rate (eGFR) was calculated by modification of diet in renal disease (MDRD) formulas? The changes of relevant indicators for cardiac and nephritic functions before and after treatment were compared during the 12-month follow-up. The study protocol was registered at the website of Chinese clinical trial register and approved by the ethics c