中西医结合治疗2型心肾综合征的临床观察(1)
[摘要] 观察中西医结合治疗2型心肾综合征的临床疗效。将入选的2型心肾综合征患者分为单纯西医治疗组(对照组)和中西医结合治疗组(治疗组)，2组患者均采用西医常规治疗，治疗组在此基础上给予补心益肾汤口服，共治疗3个疗程，观察2组患者治疗前后的总疗效、心功能指标、肾功能指标的变化情况。治疗组与对照组的总疗效分别为91.80%，72.41%。2组比较有显著性差异(P<0.01)；组内比较，治疗组与对照组在治疗前后的心功能指标、肾功能指标都有明显改善，差异有统计学意义(P<0.01)；2组治疗后心、肾功能指标比较，左室功能、血尿钠肽、血肌酐、尿素氮、胱抑素-C的改善，治疗组均优于对照组(P<0.05～0.01)。结果表明，中西医结合治疗能提高2型心肾综合征的临床疗效，明显改善心肾功能，优于单纯的西医常规治疗，且具有良好的安全性。
[关键词] 中西医结合治疗； 心肾综合征； 疗效
[Abstract] Clinical observation on treatment of type 2 cardiac and kidney syndrome by combination of traditional Chinese and Western medicine. The patients were divided into two groups： the simple Western medicine treatment group (control group) and the traditional Chinese medicine and Western medicine treatment group (treatment group). The patients in the two groups were treated with conventional western medicine.The treatment group was given based on Buxin Yishen decoction， a total of three courses of treatment to observe the two groups of patients before and after treatment of total efficacy， cardiac function indicators， changes in renal function indicators. The total efficacy of the treatment group and the control group were 91.80% and 72.41%， respectively. There were significant differences between the two groups (P<0.01). The cardiac function indexes and renal function indexes of the treatment group and the control group before and after treatment (P<0.01). Compared with the two groups， the left ventricular function， Hematuria natriuretic peptide， serum creatinine， urea nitrogen， cystatin-C were improved， and the treatment group (P<0.05～0.01). The results showed that the combination of traditional Chinese and Western medicine treatment can improve the clinical efficacy of type 2 heart and kidney syndrome， significantly improve heart and kidney function， better than conventional Western medicine treatment， and has good safety.
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[Key words] combination of traditional Chinese and Western medicines； cardiac and kidney syndrome； curative effect
隨着我国人口的老龄化和人口寿命的延长，越来越多的多脏器合并疾病是老年科医生所面临的棘手问题。其中心肾综合征(cardiorenal syndromes，CRS)就是一大难题，引起越来越多的重视，2008年世界肾脏学会议提出了心肾综合征的新定义，即心脏或肾脏中任一器官急性或慢性功能障碍时，另一器官继发急性或慢性病变的临床综合征[1]。并根据疾病发生的机制和时间顺序，将CRS分为 5 种亚型[2]。其中2型CRS(慢性心肾综合征)是老年患者最常见的类型。Ronco C等[3]于 2014 年系统总结2型心肾综合征的病理生理特征是慢性心力衰竭时，肾上腺素、血管紧张素和内皮素等缩血管物质生成的增加，尿钠肽、NO 等内源性扩血管物质敏感性减低或释放减少，使得肾脏长期处于低灌注状态，对各种损伤高度易感，从而导致肾功能障碍。根据多年的临床实践和跟踪观察，结合辨病辨证相结合的原则，本研究采用中西医结合综合治疗2型心肾综合征，取得一定疗效，现总结如下。
1 资料与方法
1.1 一般资料 所有病例均来自青岛市市立医院2013年1月—2016年12月的住院及门诊随访病人共128例，随机分为对照组63例，其中男性37例，女性26例，平均年龄73岁；治疗组65例，其中男性38例，女性27例，平均年龄76岁。2组性别、年龄、病程、病种分布及发病时间等差异无显著性。2组患者具有可比性。, 百拇医药(胡小燕 张华 荣瑗瑗 张苗海 张向农)
[关键词] 中西医结合治疗； 心肾综合征； 疗效
[Abstract] Clinical observation on treatment of type 2 cardiac and kidney syndrome by combination of traditional Chinese and Western medicine. The patients were divided into two groups： the simple Western medicine treatment group (control group) and the traditional Chinese medicine and Western medicine treatment group (treatment group). The patients in the two groups were treated with conventional western medicine.The treatment group was given based on Buxin Yishen decoction， a total of three courses of treatment to observe the two groups of patients before and after treatment of total efficacy， cardiac function indicators， changes in renal function indicators. The total efficacy of the treatment group and the control group were 91.80% and 72.41%， respectively. There were significant differences between the two groups (P<0.01). The cardiac function indexes and renal function indexes of the treatment group and the control group before and after treatment (P<0.01). Compared with the two groups， the left ventricular function， Hematuria natriuretic peptide， serum creatinine， urea nitrogen， cystatin-C were improved， and the treatment group (P<0.05～0.01). The results showed that the combination of traditional Chinese and Western medicine treatment can improve the clinical efficacy of type 2 heart and kidney syndrome， significantly improve heart and kidney function， better than conventional Western medicine treatment， and has good safety.
, http://www.100md.com
[Key words] combination of traditional Chinese and Western medicines； cardiac and kidney syndrome； curative effect
隨着我国人口的老龄化和人口寿命的延长，越来越多的多脏器合并疾病是老年科医生所面临的棘手问题。其中心肾综合征(cardiorenal syndromes，CRS)就是一大难题，引起越来越多的重视，2008年世界肾脏学会议提出了心肾综合征的新定义，即心脏或肾脏中任一器官急性或慢性功能障碍时，另一器官继发急性或慢性病变的临床综合征[1]。并根据疾病发生的机制和时间顺序，将CRS分为 5 种亚型[2]。其中2型CRS(慢性心肾综合征)是老年患者最常见的类型。Ronco C等[3]于 2014 年系统总结2型心肾综合征的病理生理特征是慢性心力衰竭时，肾上腺素、血管紧张素和内皮素等缩血管物质生成的增加，尿钠肽、NO 等内源性扩血管物质敏感性减低或释放减少，使得肾脏长期处于低灌注状态，对各种损伤高度易感，从而导致肾功能障碍。根据多年的临床实践和跟踪观察，结合辨病辨证相结合的原则，本研究采用中西医结合综合治疗2型心肾综合征，取得一定疗效，现总结如下。
1 资料与方法
1.1 一般资料 所有病例均来自青岛市市立医院2013年1月—2016年12月的住院及门诊随访病人共128例，随机分为对照组63例，其中男性37例，女性26例，平均年龄73岁；治疗组65例，其中男性38例，女性27例，平均年龄76岁。2组性别、年龄、病程、病种分布及发病时间等差异无显著性。2组患者具有可比性。, 百拇医药(胡小燕 张华 荣瑗瑗 张苗海 张向农)