清肝解郁和健脾补肾法在治疗肝火上亢型慢性肾衰合并高血压中的应用

目的:观察清肝解郁和健脾补肾法治疗肝火上亢型慢性肾衰(CRF)合并高血压患者的临床效果。方法:选取2016年6月至2018年6月京东誉美医院收治的肝火上亢型CRF合并高血压患者90例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组45例。对照组给予口服硝苯地平控释片治疗,观察组在对照组治疗基础上给予清肝解郁、健脾补肾汤治疗,每4周为1个疗程,均治疗3个疗程。比较治疗前后中医症状评分、收缩压(SBP)、舒张压(DBP)变化;比较2组临床疗效;比较治疗前后肾功能指标:尿素氮(BUN)、血肌酐(Scr)、24 h尿蛋白定量(24 hPRO);统计治疗期间2组不良反应发生情况。结果:治疗前观察组与对照组中医症状评分、SBP、DBP、BUN、Scr、24 hPRO比较,差异均无统计学意义(P>0.05),治疗后2组患者中医症状评分、SBP、DBP、BUN、Scr、24 hPRO均显著降低(P<0.05),观察组均低于对照组,差异有统计学意义(P<0.05);2组临床疗效比较,差异有统计学意义(P<0.05),且观察组总有效率显著高于对照组,差异有统计学意义(P<0.05);观察组和对照组不良反应发生率分别为2.22%和6.67%,2组比较差异无统计学意义(P>0.05)。结论:清肝解郁、健脾补肾法辅助治疗肝火上亢型CRF合并高血压疗效确切,可较好控制血压,并且可显著改善肾功能,减少不良反应发生情况。

Effects of Qinggan Jieyu and Jianpi Bushen Method on Patients with (Liver-Fire Syndrome) Chronic Renal Failure Combined with Hypertension

To observe the therapeutic effects of Qinggan Jieyu and Jianpi Bushen method in patients (liver fire syndrome) with chronic renal failure (CRF) and hypertension.Methods:A total of 90 patients with CRF and hypertension who were admitted to the Jingdongyumei Hospital from June 2016 to June 2018 were randomly divided into an observation group and a control group by random number table method, with 45 cases in each group.The control group was treated with oral nifedipine controlled-release tablets.The observation group was treated with Qing Ganjieyu and Jianpi Bushen Decoction on the basis of the control group, and all patients were treated for 3 courses, 4 weeks fore per course.Before and after treatment, the traditional Chinese medicine syndrome scores, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were compared between 2 groups.The renal function indicators including urea nitrogen (BUN), serum creatinine (Scr), 24 h urine protein quantitation (24 hPRO) were compared between the 2 groups before and after treatment.And the incidence of adverse reactions in the 2 groups during treatment were recorded.Results:There was no significant difference between the observation group and the control group before treatment in TCM syndrome scores, SBP, DBP, BUN, Scr and 24 hPRO and the difference was statistically significant (P>0.05), while the results in observation group was all lower than those of the control group after treatment, and the difference was statistically significant (P<0.05).All the results in 2 groups were significantly lower than those before treatment (P<0.05).The rank distribution of difference in clinical efficacy between 2 groups was statistically significant (P<0.05), and the total effective rate of the observation group was significantly higher than that of the control group (P<0.05).The incidence of adverse reactions in the study group and the control group were 2.22% and 6.67%, respectively, and there was no significant difference between 2 groups, the difference was statistically significant (P>0.05).Conclusion:Adjuvant therapy of Qinggan Jieyu and Jianpi Bushen method on patients (liver fire syndrome) with CRF and hypertension is effective, which could control blood pressure well, improve renal function and reduce the incidence of adverse reactions.