目的 观察丹参酮Ⅱ_A磺酸钠注射液联合百令胶囊治疗肾血管性高血压的临床疗效。方法 选取十堰市太和医院肾内科2014年1月-2015年3月收治的肾血管性高血压患者384例,随机分为对照组、丹参酮Ⅱ_A磺酸钠组、百令胶囊组、丹参酮Ⅱ_A磺酸钠+百令胶囊组,每组各96例;对照组给予常规治疗;丹参酮Ⅱ_A磺酸钠组在对照组的基础上加用丹参酮Ⅱ_A磺酸钠注射液,40~80 mg加入5%葡萄糖注射液250~500 mL中静脉滴注,1次/d;百令胶囊组在对照组的基础上口服百令胶囊4粒/次,3次/d;丹参酮Ⅱ_A磺酸钠+百令胶囊组在对照组的基础上加用丹参酮Ⅱ_A磺酸钠注射液,40~80 mg加入5%葡萄糖注射液250~500 mL中静脉滴注,1次/d,并口服百令胶囊4粒/次,3次/d,4组均连续治疗21 d。比较治疗前后4组患者的收缩压(SBP)、舒张压(DBP)、肌酐(SCr)、尿素氮(BUN)、尿微量白蛋白(mALB)和β₂微球蛋白(β₂-MG)等指标。结果 治疗后,丹参酮Ⅱ_A磺酸钠组、百令胶囊组和丹参酮Ⅱ_A磺酸钠+百令胶囊组的总有效率与对照组比较差异具有统计学意义(P<0.05),但丹参酮Ⅱ_A磺酸钠+百令胶囊组明显高于其他3组,且差异有统计学意义(P<0.05)。丹参酮Ⅱ_A磺酸钠组治疗后的SBP、DBP和SCr、BUN均较治疗前有不同程度下降,且差异具有统计学意义(P<0.05),但β₂-MG、mALB与治疗前比较差异无统计学意义;百令胶囊组治疗后的SCr、BUN和β₂-MG、mALB均较治疗前有不同程度下降,且差异具有统计学意义(P<0.05),但SBP、DBP与治疗前比较差异无统计学意义;丹参酮Ⅱ_A磺酸钠+百令胶囊组治疗后的SBP、DBP与同组治疗前、对照组和百令胶囊组比较差异均有统计学意义(P<0.05);且SCr、BUN和β₂-MG、mALB也明显降低,较同组治疗前、对照组、丹参酮Ⅱ_A磺酸钠组和百令胶囊组比较差异具有统计学意义(P<0.05)。结论 丹参酮Ⅱ_A磺酸钠注射液联合百令胶囊治疗肾血管性高血压具有较单用任一药物更强的降压及改善衰竭肾功能的作用,安全性好,具有一定的临床推广和应用价值。

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资助项目(15Y25)