真武汤对心肾综合征患者肾微循环及肾功能影响.docVIP

真武汤对心肾综合征患者肾微循环及肾功能影响 　　 摘要：目的 观察真武汤对心肾综合征患者肾微循环及肾功能的影响。方法 将80例心肾综合征患者随机分成两组，每组40例。并选取20名健康体检者作为健康组。治疗组与对照组均采用常规西药治疗，治疗组加用真武汤治疗，观察两组临床症状、中医证候积分改善情况，测定两组血肌酐(Scr)、尿素氮(BUN)、B型钠尿肽（BNP）水平，对患者右肾进行超声造影，评估肾微循环灌注情况，并与健康组比较。结果 治疗组临床疗效和中医证候疗效总有效率（85.0%和95.0%）明显高于对照组（60.0%和25.0%）。两组患者治疗前血Scr、BUN及BNP明显高于健康组(P 　　 关键词：心肾综合征；真武汤；肾微循环；肾功能 　　 中图分类号：R541 R289.5 文献标识码：B 文章编号：1672-1349（2012）01-0027-03 　　The Influence of Zhenwu Decoction on Renal Microcirculation and Renal Function in Patients with Cardiorenal Syndrome 　　Ouyang Qiufang,Huang Ziyang,You Tao,et alThe Second Affiliated People’s Hospital,Fujian University of Traditional Chinese Medicine (Fuzhou 350003) 　　 Abstract：Objective To study the effects of Zhenwu decoction (ZWD) on renal microcirculation and renal function in patients (pts) with cardiorenal syndrome (CRS).Methods Eighty pts with CRS were randomly divided into two groups:The treatment group (n=40） treated with ZWD and conventional western medicine,and the control group (n=40) treated with conventional western medicine alone.Twenty healthy individuals were as normal control group.The clinical symptoms and traditional Chinese medicine(TCM) syndrome scores were observed.The levels of blood urea nitrogen (BUN),serum creatinin (Scr),and brain natriuretic peptide (BNP) were detected before and after treatment.Renal microcirculation was evaluated by contrast-enhanced ultrasonography.All indices were compared with those in the normal control group.Results The total effective rate in clinical symptoms and TCM syndrome score in the treatment group were 85.0% and 95.0%,respectively,which were significantly higher than that in the control group (60.0% and 25.0%,respectively).Serum levels of BUN,Scr,and BNP were obviously higher before treatment in comparison with that in the normal control group (P5.5 mmol /L)；双侧肾动脉狭窄或单侧肾动脉狭窄伴孤立肾；妊娠哺乳期妇女；对血管紧张素转换酶抑制剂过敏者。两组病例的年龄、性别、基础疾病、心功能分级及肾功能不全分级差异具有可比性。另选20名同期来我院体检者为健康组，皆无心、肝、肾等重要脏器疾病。 　　1.2 治疗方法 两组患者均常规西药治疗，酌情选用苯那普利、呋塞