【作者】 李杰；

【导师】 吴逸南；

【作者基本信息】 山东中医药大学 ， 中医内科学， 2011， 硕士

【摘要】 目的:(1)探讨原发性高血压肾损害与不同中医证型的关系。(2)探讨原发性高血压肾损害患者尿微量白蛋白及肾动脉阻力指数(RI)与臂踝脉搏波传导速度(baPWV)、踝肱指数(ABI)的关系。方法:本实验共收集山东中医药大学第二附属医院2010年10月—2011年2月住院病人44例进行研究,其中男28例,女16例,平均年龄55.07岁;均符合高血压肾损害诊断标准。设计原发性高血压肾损害患者登记表,运用四诊的方法收集每个患者的病史资料、客观指标数据准确填入登记表,并参照《中药新药临床研究指导原则》及相关古代文献分别进行辩证,得出辩证证型。分析高血压肾损害患者尿微量白蛋白、RI与中医证型及PWV、ABI关系。所得结果均采用SPSS17.0统计软件包进行数据处理;计量资料结果采用±SD表示,正态分布资料采用t检验,非正态分布资料采用秩和检验,计数资料采用卡方检验;变量间的相关程度,用相关性分析。结果:44例高血压肾损害患者均进入结果分析。肝火亢盛证26例,痰湿壅盛证18例。尿微量白蛋白与中医证型的关系:肝火亢盛组与痰湿壅盛组相比无显著性差异。肾动脉阻力指数与中医证型的关系:肝火亢盛组与痰湿壅盛组相比无显著性差异。肝火亢盛组尿微量白蛋白与PWV呈正相关(P<0.05);痰湿壅盛组尿微量白蛋白与PWV呈正相关(P<0.01)。PWV与中医证型的关系:肝火亢盛组与痰湿壅盛组相比无显著性差异。结论:1.不同中医证型的原发性高血压肾损害患者的尿微量白蛋白、肾动脉阻力指数不同,反映了原发性高血压肾损害的程度与中医证型相关。2.不同中医证型的原发性高血压肾损害患者的PWV、ABI不同,但原发性高血压肾损害的动脉损伤程度与中医证型不相关。更多还原

【Abstract】 Objective:(1)Explore the relationship between essential hypertensive renal damage and the different Traditional Chinese Medicine(TCM)syndrome type (2)Explore the relationship between microalbuminuria、renal artery resistance index (RI) in patients with essential hypertensive renal impairment and and brachial-ankle pulse wave velocity (baPWV), ankle brachial index(ABI)。Methods:Collect the second of Shandong Medical University Hospital in October 2010 -2011 44 cases in February to study patients, including 28 males and 16 females, mean age 55.07 years; meet diagnostic criteria for hypertensive renal damage . Renal damage in patients with essential hypertension Design registration form, using four diagnostic methods to collect information on each patient’s medical history, objective and accurate indicator data fill in the registration form, and with reference to "guidelines for new drug clinical research of Chinese medicine" and related ancient documents separately dialectic dialectical syndrome obtained. Analyze the relationship between microalbuminuria, RI and TCM syndrome and PWV, ABI . The results are used SPSS17.0 statistical package for data processing;±SD using results of the measurement data, said normal data using t test, non-normal data using rank-sum test, chi-square test with count data; understand the variables extent of close contact with the correlation analysis. Results:44 cases of hypertensive patients with renal impairment are the result analysis. Liver dampness Kang Sheng Group in 26 cases, 18 cases of tan shi yong sheng Group. the relationship between TCM and Microalbuminuri:Liver dampness Kang Sheng Group and tan shi yong sheng Group had no significant difference. the relationship between TCM and Renal arterial resistance index: Liver dampness Kang Sheng Group and tan shi yong sheng group have no significant difference.In Liver dampness Kang Sheng Group microalbuminuria is positively correlated with PWV (P<0.05); In tan shi yong sheng Group microalbuminuria is positively correlated with PWV (P<0.01). the relationship between TCM and PWV: Liver dampness Kang Sheng group and tan shi yong sheng Group was not significant. Conclusion:1. Primary renal hypertension of different syndromes of microalbuminuria, renal artery resistance index values of different, reflecting a relationship between the degree of primary hypertension renal damage and TCM syndrome type. 2. Primary renal hypertension of different syndromes of PWV, ABI values different, but not reflecting a relationship between hypertensive renal impairment artery damage degree and TCM syndrome type。更多还原