RESUMO
Objective::To observe the efficacy of modified Qiju Dihuang pills in protecting renal function of patients with early renal impairment with syndrome of Yin deficiency and Yang hyperactivity caused by hypertension and its effect in resisting inflammation and oxidative stress, and improving endothelial function. Method::Randomly divided into control group (59 cases) and observation group (60 cases) by random number table. Patients in control got valsartan capsules, 80 mg/time, 1 time/day. And patients whose blood pressure can't be controlled were added with nifedipine tablets, 10 mg/time, 1 time/day. In addition to the therapy of control group, patients in observation group were added with modified Qiju Dihuang pills, 1 dose/day. The control group took Qiju Dihuang pills.The courses of treatment were 16 weeks. And levels of cystatin C (CysC), urinary N-acetyl-β-glucosaminidase (NAG), β2 microglobulin (β2-MG), urinary microalbumin to creatinine ratio (UACR) and emodynamics of kidney were detected. Blood pressure, systolic pressure (SBP), diastolic pressure (DBP) and blood pressure renal artery resistance index (RI) and pulsatility index (PI) were recorded, and Yin deficiency and Yang hyperactivity were scored. Levels of nitric oxide (NO), endothelin-1 (ET-1), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), adiponectin (ADPN) and nuclear factor-kappa B (NF-κB) were detected. Result::The total effective rate in observation group was 91.67%(55/60), which was higher than 76.27%(45/59) in control group (χ2=5.255, P<0.05). Levels of SBP and DBP were lower than those in control group (P<0.05). At the 16th week during the treatment, the compliance rate of blood pressure was 90.66%, which was higher than 84.13% in control group (χ2=127.65, P<0.01). And levels of CysC, β2-MG, NAG, UACR, RI, PI, ET-1, SOD, GSH-Px, IL-6, NF-κB and TNF-α were lower than those in control group (P<0.01), while levels of NO, SOD and GSH-Px were higher than those in control group (P<0.01). Conclusion::In addition to the therapy for controlling blood pressure with routine western medicine, modified Qiju Dihuang pills can reduce level of the blood pressure, and control blood pressure with the standard, with anti-inflammatory and anti-oxidative stress effects. It can also improve the vasomotor function and the flow of kidney, protect the kidney function, and reduce the degree of injury, so as to delay the process of kidney damage and improve the prognosis.
RESUMO
Objective:To explore the curative effect and mechanism of Tongnao pill in the treatment of senile posterior circulation ischemic vertigo with phlegm and blood stasis type. Method:The 80 elderly patients with posterior circulation ischemic vertigo (phlegm and blood stasis type) admitted to Gansu Provincial Hospital of Traditional Chinese Medicine were selected as the research subjects and were randomly divided into two groups according to the hospital admission number. Those with odd numbers were classified into control group and those with even numbers were classified into observation group, with 40 cases in each group. All of the patients in both groups were given basic treatment, and the patients in control group additionally received intravenous infusion of vinpocetine on the basis of basic treatment, while the patients in observation group additionally received Tongnao pill on the basis of the treatment in control group. The clinical efficacy, traditional Chinese medicine (TCM) syndrome score, European Evaluation of Vertigo(EEV) score, dizziness handicap inventory-screening (DHI-S) score, vertebral basilar artery average blood flow velocity(Vm) and pulsatility index(PI), hemodynamic changes[mean arterial pressure(MAP), central venous pressure(CVP), right atrial pressure (RAP), left atrial pressure(LAP), cardiac output(CO), cardiac stroke volume(SV)], changes in blood viscosity and blood lipid levels，symptom disappearance time, and safety of the two groups were compared. Result:The total effective rate in the observation group was 95.00% (38/40), significantly higher than 75.00% (30/40) in the control group (χ2=4.804, P<0.05). After treatment, the symptoms were significantly improved in both groups (P<0.05), and the scores of dizziness, nausea and vomiting, tinnitus and deafness, tiredness and fatigue in the observation group were lower than those in the control group (P<0.05), the EEV and DHI-S scores were decreased significantly in both groups(P<0.05), and such scores in the observation group were significantly lower than those in the control group(P<0.05), the Vm of bilateral vertebral artery (VA) and basilar artery (BA) on both sides were significantly increased in both groups, while the PI was significantly reduced (P<0.05), and these two indicators in the observation group were better than those in the control group (P<0.05), the MAP, CVP, RAP and LAP were significantly reduced in both groups after treatment, while the CO and SV were increased after treatment(P<0.05), and the SV of the observation group was significantly higher than that of the control group(P<0.05). The high blood viscosity, low blood viscosity, plasma viscosity and TG, TC, LDL-C levels were decreased significantly while HDL-C increased significantly in both groups (P<0.05), and the blood viscosity and blood lipid levels in the observation group were significantly better than those in the control group(P<0.05). The time to disappearance of dizziness, nausea, vomiting, tinnitus and deafness, malaise, fatigue, and confused mind in observation group was less than that in the control group (P<0.05), no serious adverse events occurred in both groups. Conclusion:Tongnao pills for the treatment of senile posterior circulation ischemic vertigo (phlegm and blood stasis type) can significantly alleviate the symptoms of vertigo, improve hemorrheology, increase the blood flow velocity of the vertebrobasilar artery, improve the abnormal blood supply to the brain, and improve the quality of life for patients, with fewer adverse reactions, high safety, and good therapeutic effect. Therefore, it is worth to be applied in clinical use.