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目的探讨尿毒清颗粒合并氯沙坦治疗高血压合并高尿酸血症的临床疗效。方法选择2015年1月—2016年3月瑞安市人民医院收治的168例高血压合并高尿酸血症的患者,采用随机数字法分为观察组和对照组,每组84例。对照组采用氯沙坦治疗,观察组在氯沙坦基础上加用尿毒清颗粒。治疗前后,检测2组患者的血压和尿酸相关指标[收缩压(SBP)、舒张压(DBP)和血尿酸(UA)],内皮细胞功能[一氧化氮(NO)、血管性假性血友病因子(v WF)]、RAS活性相关指标[血浆卧位肾素、血管紧张素Ⅱ(AngⅡ)]、血脂相关指标[甘油三酯(TG)、胆固醇(TCG)、高密度脂蛋白(HDL-C)],并统计不良反应发生率和治疗效果。结果治疗后,2组SBP、DBP、血尿酸、v WF、卧位肾素、AngⅡ、TG、TCG均明显降低(P<0.05),且观察组各指标显著低于对照组(P<0.05);治疗后,2组NO水平均明显升高(P<0.05),且观察组NO水平明显高于对照组(P<0.05)。观察组总有效率为91.7%,显著高于对照组的79.8%(P<0.05)。结论尿毒清颗粒合并氯沙坦可抑制RAS系统过度激活,改善内皮细胞功能,有效降低患者血压和血尿酸含量,治疗效果满意。
Objective To investigate the clinical efficacy of Niaoduqing granule combined with losartan in the treatment of hypertension and hyperuricemia. Methods A total of 168 patients with hypertension and hyperuricemia who were admitted to Rui’an People’s Hospital from January 2015 to March 2016 were randomly divided into observation group and control group with 84 cases in each group. The control group was treated with losartan. The observation group was given losartan plus uremic clear granules. Before and after treatment, blood pressure and uric acid-related indicators (SBP, DBP and UA), endothelial cell function [nitric oxide (NO), von Willebrand factor (VWF)], RAS activity-related index [plasma rennin and angiotensin II (Ang II)], blood lipid related indicators [triglyceride (TG), cholesterol (TCG), high density lipoprotein -C)], and statistical incidence of adverse reactions and treatment. Results After treatment, SBP, DBP, serum uric acid, vWF, supine renin, AngⅡ, TG and TCG in the two groups were significantly lower than those in the control group (P <0.05) After treatment, the levels of NO in both groups were significantly increased (P <0.05), and the levels of NO in the observation group were significantly higher than those in the control group (P <0.05). The total effective rate in the observation group was 91.7%, significantly higher than 79.8% in the control group (P <0.05). Conclusion The combination of niuduqing granule and losartan can inhibit the over activation of RAS system, improve the function of endothelial cells and effectively reduce the blood pressure and serum uric acid in patients. The treatment effect is satisfactory.