| Objective:To explore the accuracy of test strips for detecting microalbuminuria and investigate risk factors leading to elevated urinary albumin,observe the correlation between TCM syndrome differentiation type and microalbuminuria in hypertension and investigate the effect of Lingzhi Capsule combined with angiotensin Ⅱ receptor antagonists in the treatment of hypertensive with microalbuminuria and the differences in efficacy between TCM syndromes.Method:This study was included 519 patients with primary hypertension who were admitted to the Cardiovascular Outpatient Clinic of Jiangsu Province Hospital of TCM and a community health service center in Gulou District of Nanjing from March 2016 to January 2018,Collect basic clinical data through questionnaire survey and make TCM judgments,"Urinary microalbumin" and "Microscale albuminuria" were measured in each patient using a 14-fold urinalysis test strip,analyze whether the degree of urinary microalbumin is related to age,pulse pressure,duration,and body mass index,Calculate urine album in-creatinine ratio.Then 150 patients were selected according to the randominzation principle and the positive rate of microabuminuria was detected by immunoturbidimetry.And compare it with test paper test results,evaluate the Sensitivity of Test Strips to detect microalbuminuria.According to the diagnostic criteria of TCM syndrome type,the patients were divided into the phlegm and dampness group,yin deficiency and yang hyperactivity group,liver fire hyperactivity group,Yin and Yang deficiency group and compare the differences between groups.The patients with microalbuminuria positive were divided into treatment group and control group according to the principle of randomization,The control group was given conventional antihypertensive drugs(including an angiotensin Ⅱ receptor antagonist),The treatment group was added toLingzhi mycelium capsules on the Routine hypotensive therapy.Retest urine album in-creatinine ratio after 28 days of continuous treatment and Comparing the difference between the negative rate of microalbuminuria in the test group and the control group,compare the difference in microalbuminuria conversion rate between TCM syndrome groups.Results:①Compare the microalbuminuria test results between test strip method and immunoturbidimetry method,The Youden index is 0.876,the area under the ROC curve is 0.938,The Test strip is sensitive and convenient to detect microalbuminuria;②Assuming that urinary albumin elevation is related to factors such as age,disease duration,body mass index,and pulse pressure,according to regression analysis,The results showed a significant correlation between pulse pressure and body mass index,the results were statistically significant(P<0.05).③Microalbuminuria was detected in 209 of 519 patients with hypertension,The detection rate of microalbuminuria was 40.27%,The positive rate of microalbuminuria from high to low in various syndromes was syndrome of phlegm and dampness>syndrome of yin deficiency and yang hyperactivity>syndrome of Yin and Yang deficiency>syndrome of liver fire hyperactivity;④After 28 days of treatment,the MAU conversion rate of the treatment group was significantly better than control group(P<0.01).⑤The conversion rate of microalbuminuria in the treatment group:phlegm and dampness group was 43.24%,yin deficiency and yang hyperactivity group was 78.57%,liver fire hyperactivity group was 75%,Yin and Yang deficiency group was 100.00%.There was a statistically significant difference between the Yin Yang deficiency syndrome group and the other three groups(P<0.05).Conclusions:①The detection rate of microalbuminuria was high,simple and rapid,and could be used in large-scale epidemiological investigation of community hospitals and self-measurement of patients,so as to detect early renal damage of hypertension.②Potassium pulse pressure and body mass index are positively correlated with the degree of urinary microalbumin,suggesting that patients with early renal impairment in hypertension should pay attention to the control of pulse pressure and body weight.The tratment of Routine hypotensive therapy combine Lingzhi mycelium capsules Can effectively reduce the Urinary microalbuminn,increase high blood pressure in patients with microalbuminuria merger of microalbuminuria,overcast rate of hypertensive renal damage has certain protective effect,worthy of clinical use.④Hypertensive with microalbuminuria positive rate is as high as 40.27%,therefore,should pay attention to early detect microalbuminuria,renal protection treatment time point in advance in order to improve the connotation of antihypertensive treatment,get a better long-term prognosis. |
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