目的 觀察丹參酮Ⅱ_A磺酸鈉注射液聯(lián)合百令膠囊治療腎血管性高血壓的臨床療效。方法 選取十堰市太和醫(yī)院腎內(nèi)科2014年1月-2015年3月收治的腎血管性高血壓患者384例,隨機(jī)分為對(duì)照組、丹參酮Ⅱ_A磺酸鈉組、百令膠囊組、丹參酮Ⅱ_A磺酸鈉+百令膠囊組,每組各96例;對(duì)照組給予常規(guī)治療;丹參酮Ⅱ_A磺酸鈉組在對(duì)照組的基礎(chǔ)上加用丹參酮Ⅱ_A磺酸鈉注射液,40~80 mg加入5%葡萄糖注射液250~500 mL中靜脈滴注,1次/d;百令膠囊組在對(duì)照組的基礎(chǔ)上口服百令膠囊4粒/次,3次/d;丹參酮Ⅱ_A磺酸鈉+百令膠囊組在對(duì)照組的基礎(chǔ)上加用丹參酮Ⅱ_A磺酸鈉注射液,40~80 mg加入5%葡萄糖注射液250~500 mL中靜脈滴注,1次/d,并口服百令膠囊4粒/次,3次/d,4組均連續(xù)治療21 d。比較治療前后4組患者的收縮壓(SBP)、舒張壓(DBP)、肌酐(SCr)、尿素氮(BUN)、尿微量白蛋白(mALB)和β₂微球蛋白(β₂-MG)等指標(biāo)。結(jié)果 治療后,丹參酮Ⅱ_A磺酸鈉組、百令膠囊組和丹參酮Ⅱ_A磺酸鈉+百令膠囊組的總有效率與對(duì)照組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05),但丹參酮Ⅱ_A磺酸鈉+百令膠囊組明顯高于其他3組,且差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。丹參酮Ⅱ_A磺酸鈉組治療后的SBP、DBP和SCr、BUN均較治療前有不同程度下降,且差異具有統(tǒng)計(jì)學(xué)意義(P<0.05),但β₂-MG、mALB與治療前比較差異無(wú)統(tǒng)計(jì)學(xué)意義;百令膠囊組治療后的SCr、BUN和β₂-MG、mALB均較治療前有不同程度下降,且差異具有統(tǒng)計(jì)學(xué)意義(P<0.05),但SBP、DBP與治療前比較差異無(wú)統(tǒng)計(jì)學(xué)意義;丹參酮Ⅱ_A磺酸鈉+百令膠囊組治療后的SBP、DBP與同組治療前、對(duì)照組和百令膠囊組比較差異均有統(tǒng)計(jì)學(xué)意義(P<0.05);且SCr、BUN和β₂-MG、mALB也明顯降低,較同組治療前、對(duì)照組、丹參酮Ⅱ_A磺酸鈉組和百令膠囊組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 丹參酮Ⅱ_A磺酸鈉注射液聯(lián)合百令膠囊治療腎血管性高血壓具有較單用任一藥物更強(qiáng)的降壓及改善衰竭腎功能的作用,安全性好,具有一定的臨床推廣和應(yīng)用價(jià)值。

Objective To observe the clinical effects of Tanshinone Ⅱ_A Sodium Injection combined with Corbrin Capsules in treatment of renal vascular hypertension. Methods Patients (384 cases) with renal vascular hypertension in Department of Nephrology of Taihe Hospital Nephrology from January 2014 to March 2015 were randomly divided into control group, Tanshinone Ⅱ_A Sodium group, Corbrin Capsules group, and Tanshinone Ⅱ_A Sodium + Corbrin Capsules group. Each group had 96 cases. The patients in control group were given conventional therapy. The patients in Tanshinone Ⅱ_A Sodium group were iv administered with Tanshinone Ⅱ_A Sodium Injection on the basis of control group, 40-80 mg added into 5% Glucose Injection 250-500 mL, once daily. The patients in Corbrin capsules group were po administered with Corbrin Capsules on the basis of control group, 4 grains/time, three times daily. The patients in Tanshinone Ⅱ_A Sodium + Corbrin Capsules group were iv administered with Tanshinone Ⅱ_A Sodium Injection on the basis of control group, 40-80 mg added into 5% Glucose Injection 250-500 mL, once daily, and were po administered with Corbrin Capsules, 4 grains/time, three times daily. The patients in four groups were treated for 21 d. Systolic blood pressure (SBP), diastolic blood pressure (DBP), serum creatinine (SCr), blood urea nitrogen (BUN), urinary albumin (mALB), and β₂-microglobulin (β₂-MG) in four groups were compared. Results After treatment, the clinical efficacies in Tanshinone Ⅱ_A Sodium group, Corbrin Capsules group, and Tanshinone Ⅱ_A Sodium + Corbrin Capsules group were higher than that in control group, and there were significant differences between four groups (P < 0.05). But the clinical efficacy in Tanshinone Ⅱ_A Sodium + Corbrin Capsules group was significantly higher than that in the other three groups, and the difference was statistically significant (P < 0.05). After treatment, SBP, DBP and SCr, BUN in Tanshinone Ⅱ_A Sodium group were decreased, and there were significant differences (P < 0.05). But there was no significant difference between before and after treatment in β₂-MG and mALB. SCr, BUN and β₂-MG, mALB in Corbrin Capsules group decreased to varying degrees than those before treatment, and the difference was statistically significant (P < 0.05). But there was no significant difference in SBP and DBP between before and after treatment. There were significant differences between SBP and DBP in Tanshinone Ⅱ_A Sodium + Corbrin Capsules group after treatment between those before treatment, in control group, and in Corbrin Capsules group (P < 0.05). And SCr, BUN, and β₂-MG, mALB also significantly reduced compared with those before treatment, in control group, and in Corbrin Capsules group, and the difference was statistically significant (P < 0.05). Conclusion Tanshinone Ⅱ_A Sodium Injection combined with Corbrin Capsules in treatment of renal vascular hypertension has better effects of antihypertension and improving the renal function with high safety, which has a certain clinical application value.

湖北省十堰市科技局資助項(xiàng)目(15Y25)