针药结合与单纯药物治疗肾性高血压疗效观察

目的:探讨提高治疗慢性肾脏病肾性高血压临床疗效的方法。方法:将152例患者随机分为针药结合组和药物组,每组76例。针药结合组采用针刺平衡"降压穴"和"肾病穴"为主,配合小剂量降压药伊贝沙坦;药物组采用口服伊贝沙坦、福辛普利治疗。观察2组的临床疗效并进行比较。结果:治疗4周后针药结合组56.58%的患者血压达到目标值[DBP≤84.96mmHg(1mmHg=0.133kPa)];药物组53.95%达到目标值,2组比较差异无显著性意义(P>0.05)。治疗8周和24周时组间比较,针药结合组降压效果优于药物组(P<0.01)。2组治疗后尿蛋白排泄减少、血肌酐下降、内生肌酐清除率上升(P<0.01)。结论:针刺结合少量药物与单纯药物治疗慢性肾性高血压的临床疗效相同。随治疗时间的延长,针药结合的疗效和优越性明显优于单纯药物。

Observation on therapeutic effects of combined acupuncture and medicine therapy and simple medication on renal hypertension of chronic kidney disease

OBJECTIVE: To probe into a method for increasing clinical therapeutic effect on renal hypertension of chronic kidney disease. METHODS: One hundred and fifty-two cases were randomly divided into a combined acupuncture and medicine group and a medication group, 76 cases in each group. The combined acupuncture and medicine group were treated with acupuncture balance points "Jiangya" and "Shenbing" as main, combined with small dose of hypotensor, Irbesartan; and the medication group were treated with oral administration of Irbesartan and Fosinopril. Their clinical therapeutic effects were compared. RESULTS: After treatment of 4 weeks, 56.58% of the patients in the combined acupuncture and medicine group reached to the objective value [DBP < or = 84.96 mm Hg (1 mm Hg= 0.133 kPa)], and 53.95% of the patients in the medication group reached to the objective value, with no significant difference between the two groups (P > 0.05). After treatment of 8 weeks and 24 weeks, the blood pressure-decreasing effect in the combined acupuncture and medicine group was better than that of the medication group (P < 0.01). After treatment, protein in the urine decreased and blood creatinine reduced, the clearance rate of endogenous creatinine raised in the two groups, with very significant differences (P < 0.01). CONCLUSION: Acupuncture combined with small dose of medicine and simple medicine have a same therapeutic effect on renal hypertension of chronic kidney disease, but with prolongation of treatment time, the therapeutic effect and advantages of the combined acupuncture and medicine therapy were superior to the medication.