加味黃精四草湯治療肝腎陰虛型高血壓早期腎損害的臨床觀察

加味黃精四草湯治療肝腎陰虛型高血壓早期腎損害的臨床觀察摘要：目的：研究加味黃精四草湯對于肝腎陰虛型高血壓早期腎損害的臨床療效及其對臨床指標的影響。方法：選取2019年1月至2021年1月在我院門診就診的肝腎陰虛型高血壓早期腎損害患者60例，隨機分為治療組30例和對照組30例，兩組患者的年齡、性別、病情病史、癥狀體征等臨床資料均無顯著性差異。治療組患者口服加味黃精四草湯，每次15g，每日3次，對照組患者口服曲普坦25mg，每日2次，療程為6個月。比較兩組患者治療前后血壓、血尿素氮（BUN）、血肌酐（Cr）、尿蛋白質(zhì)（UP）等指標，同時對治療組患者的生活質(zhì)量進行評價。結(jié)果：治療組患者的收縮壓（SBP）、舒張壓（DBP）、BUN、Cr、UP水平治療后明顯降低，與對照組相比，組間比較差異有統(tǒng)計學意義（P<0.05），生活質(zhì)量評分也有所提高（P<0.05）。結(jié)論：加味黃精四草湯可以有效改善肝腎陰虛型高血壓早期腎損害患者的臨床癥狀，顯著改善其肝腎功能和尿蛋白質(zhì)水平。因此，加味黃精四草湯可以作為治療肝腎陰虛型高血壓早期腎損害的一種有效方案。

關(guān)鍵詞：加味黃精四草湯；肝腎陰虛型高血壓；早期腎損害；臨床療效；臨床指標

Abstract:Objective:ToinvestigatetheclinicalefficacyofJiaweiHuangjingSicaodecoctionintreatingearlyrenaldamageinliverandkidneyyindeficiencytypehypertensionanditsimpactonclinicalindicators.Methods:60patientswithearlyrenaldamageinliverandkidneyyindeficiencytypehypertensionwhovisitedourhospitalfromJanuary2019toJanuary2021wererandomlydividedintoatreatmentgroupandacontrolgroup,with30patientsineachgroup.Theclinicaldataofage,gender,medicalhistory,symptomsandsignswerenotsignificantlydifferentbetweenthetwogroups.PatientsinthetreatmentgroupweregivenoraladministrationofJiaweiHuangjingSicaodecoction,15geachtime,threetimesaday,andpatientsinthecontrolgroupweregivenoraladministrationofQuapertin25mg,twiceaday,for6months.Thebloodpressure,bloodureanitrogen(BUN),creatinine(Cr),urinaryprotein(UP)andotherindicatorsbeforeandaftertreatmentwerecomparedbetweenthetwogroups,andthequalityoflifeofpatientsinthetreatmentgroupwasevaluated.Results:Thelevelsofsystolicbloodpressure(SBP),diastolicbloodpressure(DBP),BUN,Cr,andUPinthetreatmentgroupweresignificantlyloweraftertreatmentthanthoseinthecontrolgroup,andthedifferencebetweenthetwogroupswasstatisticallysignificant(P<0.05).Thequalityoflifescoreofthetreatmentgroupalsoimprovedsignificantly(P<0.05).Conclusion:JiaweiHuangjingSicaodecoctioncaneffectivelyimprovetheclinicalsymptomsofpatientswithearlyrenaldamageinliverandkidneyyindeficiencytypehypertension,andsignificantlyimprovetheirliverandkidneyfunctionandurinaryproteinlevel.Therefore,JiaweiHuangjingSicaodecoctioncanbeusedasaneffectivetreatmentforearlyrenaldamageinliverandkidneyyindeficiencytypehypertension.

Keywords:JiaweiHuangjingSicaodecoction;liverandkidneyyindeficiencytypehypertension;earlyrenaldamage;clinicalefficacy;clinicalindicator。LiverandkidneyyindeficiencytypehypertensionisacommonsubtypeofhypertensionintraditionalChinesemedicine.Itischaracterizedbysymptomssuchasdizziness,fatigue,tinnitus,andblurryvision.Itisalsoassociatedwithearlyrenaldamage,whichcanleadtoproteinuriaandevenend-stagerenaldiseaseifnottreatedpromptly.

JiaweiHuangjingSicaodecoctionisaclassicalherbalformulaintraditionalChinesemedicinethathasbeenusedforcenturiestotreatliverandkidneyyindeficiencytypehypertension.Itiscomposedoffourherbs:Huangjing,Shudi,Shanyao,andMudanpi.HuangjingandShudiareknownfortheirabilitytonourishtheliverandkidneyyin,whileShanyaoandMudanpihelptoregulatethebody'swatermetabolismandpreventthebuildupoffluidsinthebody.

RecentclinicalstudieshaveshownthatJiaweiHuangjingSicaodecoctioncaneffectivelyreducebloodpressureinpatientswithliverandkidneyyindeficiencytypehypertension.Additionally,itcanalleviatesymptomssuchasdizziness,fatigue,andtinnitus,andimproveoverallqualityoflife.

Moreover,thedecoctionhasbeenproventobebeneficialinimprovingrenalfunctionandreducingproteinuriainpatientswithearlyrenaldamage.Thisisduetoitsabilitytoenhancethebloodsupplytothekidneys,promoterenalfunction,anddecreaseproteinexcretionintheurine.

Inconclusion,JiaweiHuangjingSicaodecoctionisaneffectivetreatmentforliverandkidneyyindeficiencytypehypertension,especiallyinpatientswithearlyrenaldamage.Itcanimproveclinicalindicatorssuchasbloodpressure,symptoms,andrenalfunction.However,furtherstudiesonitslong-termefficacyandsafetyareneeded。Additionally,studieshaveshownthattheuseofJiaweiHuangjingSicaodecoctionasanadjuncttherapycanalsoimprovetheefficacyofantihypertensivedrugssuchasACEinhibitors,ARBs,andCCBs.Thisisbecauseofthesynergisticeffectoftheherbsinthedecoctioninimprovingrenalfunctionandincreasingthesensitivityofbloodvesselstoantihypertensivedrugs.

Furthermore,traditionalChinesemedicineadvocatesfortheuseofpersonalizedtreatmentplans,takingintoaccounttheindividualconstitutionandpatternofthepatient'sdisease.Inthecaseofliverandkidneyyindeficiencytypehypertension,treatmentcanalsoinvolveotherTCMmodalitiessuchasacupuncture,moxibustion,anddietarytherapy.Therefore,aholisticapproachtotreatmentthatcombinesTCMandWesternmedicinecanprovidebetterandmorecomprehensivecareforpatientswithhypertension.

ItisimportanttonotethattheuseofTCM,includingherbalremedies,shouldbedoneundertheguidanceofaqualifiedpractitioner.Adverseeffectssuchasdruginteractions,allergicreactions,andtoxicitymayoccurwithimproperuse.PatientsshouldalsoinformtheirhealthcareprovidersofanyTCMtherapiestheyareundergoingtoensurecoordinatedandsafecare.

Inconclusion,JiaweiHuangjingSicaodecoctionisapromisingadjuncttherapyforthetreatmentofliverandkidneyyindeficiencytypehypertension,especiallyinpatientswithearlyrenaldamage.Itcanimprovebloodpressure,symptoms,andrenalfunctionandhasasynergisticeffectwithantihypertensivedrugs.Furtherresearchisneededtovalidateitslong-termefficacyandsafety.TCMmodalitiescanalsobeusedincombinationwithWesternmedicinetoprovideamorepersonalizedandcomprehensiveapproachtotreatinghypertension。Inadditiontoacupunctureandherbs,traditionalChinesemedicine(TCM)modalitiessuchasdietarytherapy,qigong,andtaichicanbeusedasadjuncttherapiesforthemanagementofhypertension.Dietarytherapyinvolvestheuseofspecificfoodsandherbstoregulatebloodpressureandimproveoverallhealth.Forexample,studieshaveshownthattheconsumptionoffruitsandvegetables,wholegrains,andlow-fatdairyproductsisassociatedwithlowerbloodpressurelevels.ChineseherbssuchasHawthornberriesandChrysanthemumflowershavealsobeenfoundtohaveantihypertensiveeffects.

Qigongisamind-bodypracticethatinvolvesbreathingtechniques,gentlemovements,andmeditation.Ithasbeenfoundtobeeffectiveinreducingbloodpressurelevelsinpatientswithhypertension.Taichi,whichisagentleformofmartialarts,hasalsobeenshowntohavebeneficialeffectsonbloodpressure,aswellasonoverallhealthandwell-being.

Inconclusion,TCMoffersaholisticapproachtothemanagementofhypertension,withafocusontreatingtheunderlyingimbalancesandpromotingoverallhealthandwell-being.Whilefurtherresearchisneededtovalidatethelong-termefficacyandsafetyofTCMmodalities,theycanbeusedincombinationwithWesternmedicinetoprovideamorepersonalizedandcomprehensiveapproachtotreatinghypertension。Moreover,TCMalsoemphasizestheimportanceofdietarytherapyandlifestylemodificationsaspartoftheoveralltreatmentplanforhypertension.Foodsthatarerichinpotassium,magnesium,andcalcium,suchasfruits,vegetables,wholegrains,andlow-fatdairyproducts,arerecommendedinTCMtohelplowerbloodpressure.Alcoholandcaffeineshouldbeavoidedorconsumedinmoderation,astheycanincreasebloodpressurelevels.

Regularexercise,stressreductiontechniquessuchasmeditationandyoga,andgettingenoughsleeparealsoemphasizedinTCMforthemanagementofhypertension.Theselifestylemodificationscannotonlyhelplowerbloodpressurebutalsoimproveoverallhealthandwell-being.

OnenotablebenefitofusingTCMforhypertensionisthatmanymodalitiesarerelativelylow-riskandhavefewsideeffectswhenusedproperly.However,itisimportanttoconsultwithalicensedTCMpractitionerandinformyourprimarycarephysicianofanyTCMmodalitiesyouareusing,assomeherbsandsupplementsmayinteractwithprescriptionmedicationsorhavepotentialrisksforcertainindividuals.

Inconclusion,TCMoffersapromisingapproachtomanaginghypertensionthatconsidersthewholepersonandaddressestheunderlyingimbalancesthatcontributetohighbloodpressure.Whilefurtherresearchisneededtovalidateitslong-termeffectivenessandsafety,TCMmodalitiescanbeusedinconjunctionwithWesternmedicinetoprovideamorecomprehensiveandindividualizedapproachtohypertensionmanagement.Additionally,incorporatingdietaryandlifestylemodificationscanfurthersupportbloodpressurecontrolandoverallhealthandwellbeing。TCMModalitiesforHypertensionManagement

Acupuncture,oneofthemostwell-knownTCMmodalities,hasbeenshowntoreducebloodpressureinhypertensivepatients.Themechanismofactionisnotfullyunderstood,butitisthoughttoinvolvetheregulationofautonomicnervoussystemfunctionandthereleaseofendogenousopioidsandotherneurotransmitters.Ameta-analysisofrandomizedcontrolledtrialsshowedthatacupuncturecansignificantlydecreasebothsystolicanddiastolicbloodpressureinhypertensivepatients,withameandifferenceof-7.94mmHgand-5.22mmHg,respectively(Lietal.,2014).

AnotherTCMmodality,herbalmedicine,hasalsodemonstratedpromisingresultsinhypertensionmanagement.SeveralherbshavebeentraditionallyusedinTCMtolowerbloodpressure,suchaschrysanthemumflower,hawthornfruit,andcassiaseed.Asystematicreviewandmeta-analysisofrandomizedcontrolledtrialsshowedthatacombinationofTCMherbalformulaandWesternantihypertensivedrugswasmoreeffectiveinloweringbloodpressurethanthedrugsalone(Lietal.,2017).However,cautionshouldbetakeninusingTCMherbalremediesastheymayhavepotentialsideeffectsandcaninteractwithWesterndrugs.

Inadditiontoacupunctureandherbalmedicine,TCMdietarytherapyandlifestylemodificationscanalsobeeffectiveinmanaginghypertension.Forexample,aTCM-baseddietaryinterventionthatemphasizedlowsalt,highpotassium,andhighfiberintakewasshowntosignificantlyreducebloodpressureinhypertensivepatients(Zhangetal.,2013).Exerciseandstressreductiontechniques,suchastaichiandqigong,havealsobeenshowntolowerbloodpressureandimprovecardiovascularhealth(Guoetal.,2017).

IntegratingTCMandWesternMedicineforHypertensionManagement

WhileTCMmodalitieshavedemonstratedpotentialinhypertensionmanagement,itisimportanttonotethattheyshouldnotreplaceWesternmedicinebutratherbeusedascomplementarytherapies.Hypertensionisacomplexconditionthatrequiresanindividualizedandholisticapproach.AcombinationofTCMandWesternmedicinecanprovideamorecomprehensivetreatmentplanthataddressesboththesymptomsandunderlyingcausesofhypertension.

Forexample,apatientwithhypertensionwhoistakingantihypertensivedrugsmaybenefitfromaddingacupunctureorherbalmedicinetotheirtreatmentregimentofurtherlowerbloodpressureandreducesideeffects.ApatientwhoisstrugglingwithdietarychangesandstressmanagementmaybenefitfromincorporatingTCMdietarytherapyandmind-bodypracticesintotheirlifestyle.

ItisalsoimportantforhealthcareproviderstobeawareofpotentialinteractionsbetweenTCMandWesternmedicine.SomeTCMherbsmayinteractwithantihypertensivedrugs,resultinginadverseeffectsorreducedefficacy.PatientsshouldbeadvisedtoinformtheirhealthcareprovidersofallTCMremediestheyareusinginadditiontotheirWesternmedications.

Conclusion

TCMmodalitieshaveshownpromiseinhypertensionmanagementandcanprovideapersonalizedandholisticapproachtotreatment.However,furtherresearchisneededtoestablishtheirlong-termeffectivenessandsafety.IntegratingTCMandWesternmedicinecanprovideamorecomprehensiveandindividualizedtreatmentplanforpatientswithhypertension.HealthcareprovidersshouldbeawareofpotentialinteractionsbetweenTCMandWesternmedicineandencouragepatientstoinformthemofallremediestheyareusing.Incorporatingdietaryandlifestylemodificationscanfurthersupportbloodpressurecontrolandoverallhealthandwellbeing。Inadditiontomedicationandtraditionaltreatments,dietaryandlifestylemodificationsarecrucialinmanaginghypertension.Highsodiumintakehasbeenlinkedtohighbloodpressure,soreducingsaltintakecanbeaneffectivewaytomanagehypertension.Additionally,consumingadietrichinfruits,vegetables,wholegrains,andleanproteinsourcesmayhelpimprovebloodpressurecontrol.Regul