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1、中西醫(yī)結(jié)合心腦血管病雜志2014年2月第12卷第2期·129·臨床醫(yī)學(xué)論著中醫(yī)交通心腎法延緩心腎綜合征急性惡化的機(jī)制探討周育平,褚瑜光,耿彥婷,張振鵬,杜柏,安成,胡元會(huì)摘要:目的探討交通心腎法代表方復(fù)方交泰湯延緩心腎綜合征(cardiorenalsyndrome,CRS)急性惡化的機(jī)制。方法將6O例CRS患者隨機(jī)分為治療組和對(duì)照組,給予規(guī)范的西藥治療,治療組加用復(fù)方交泰湯煎劑,療程14d±3d。觀察兩組患者心,g-功能、腎素一血管緊張素一醛固酮系統(tǒng)(RAAs)指標(biāo)、超敏C反應(yīng)蛋白(hs—CRP)的變化。結(jié)果兩組治療后紐約心臟病協(xié)會(huì)(NYHA)心功能分級(jí)較治療前明顯改善(P<0.01);治
2、療組治療后B型腦鈉肽(NT—proBNP)明顯下降(P<0.01);對(duì)照組治療后血肌酐(Cr)、尿素氮(BUN)較治療前明顯升高(P<0.05),治療組治療后BuN有所下降(P<0.05);治療組治療后血紅蛋白(Hb)較治療前下降(P<0.01);兩組治療后血胱氨酸蛋白酶抑制物C(Cys—c)較治療前均有下降(P<0.05或P<0.01);治療組尿微量白蛋白(mAIB)、尿腎損傷分子一1(Kim一1)呈現(xiàn)下降趨勢(shì)(P<0.01);治療組中醫(yī)證候療效優(yōu)于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05);治療組治療后醛固酮(ALD)、hs—CRP明顯下降,與治療前比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。
3、結(jié)論交通心’g-法代表方復(fù)方交泰湯能延緩心、腎功能惡化,其可能機(jī)制是對(duì)抗RAAS過(guò)度激活和機(jī)體炎癥反應(yīng)。關(guān)鍵詞:心腎綜合征;交通心腎法;’g-素一血管緊張素一醛固酮系統(tǒng);炎癥反應(yīng)中圖分類號(hào):41.6P,256.2文獻(xiàn)標(biāo)識(shí)碼:Adoi:10.3969/j.issrL1672—1349.2014.02.001文章編號(hào):1672—1349(2014)02—0129—03AcuteExacerbationofCardiorenalSyndromePostponedbyRestoringNormalCoordinationbetweenHeartandKidneyZhouYuping,ChuYugu
4、ang,GengYanting,etalDepartmentofCardiology,Guang’anmenHospital,ChinaAcademyofChineseMedicalSciences(Beijing100053)Abstract:ObjectiveTostudythemechanismforpostponingtheacuteexacerbationofcardiorenalsyndromebyFufangJiaotaide—coctionbasedonrestoringnormalcoordinationbetweenheartandkidney.MethodsSixty
5、patientswererandomlydividedintocontrolgrouptreatedwithspecificationwesternmedicineandtreatmentgrouptreatedwithtraditionalChinesemedicine,F(xiàn)ufangJiaotaidecoc—iton.Heartandkidneyfunction,RAASandhs—CRPwereobservedaftertreatmentfor14±3days.ResultsNYHAwereimprovedaftertreatmentintwogrouppatients.Itw3ssi
6、gnificantlydifferentcomparedwiththatbeforetreatment(P<0.01).Theleve1ofNT—proBNPintreatmentgroupwasobviouslydecreasedaftertreatment(PO.05).ThelevelsofCrandBUNincontrolgroupwereincreasedaftertreatmentandhadsig—nificantdiff
7、erencewiththosebeforetreatment(P