松龄血脉康胶囊联合杞菊地黄丸对肝肾亏虚兼血瘀证老年高血压患者血管内皮功能的影响

目的:探讨松龄血脉康胶囊联合杞菊地黄丸治疗老年高血压(肝肾亏虚兼血瘀证)患者的临床疗效及对血管内皮功能的影响。方法:将147例患者随机按数字表法分为西医组(74例)和联合组(73例)。西医组口服非洛地平缓释片,5~10 mg/次,1次/d;口服氯沙坦钾氢氯噻嗪片,1片/次,1次/d。联合组西药治疗同西医组,并加服松龄血脉康胶囊,2粒/次,3次/d;杞菊地黄丸,9 g/次,2次/d。两组疗程均为12周。监测治疗前后血压水平,计算血压达标率;采用彩色多普勒超声诊断仪测量治疗前后肱动脉介导内皮依赖性舒张功能(FMD);采用全自动动脉硬化测定仪检测治疗前后脉搏波传导速度(PWV),包括踝臂动脉(ba PWV)和颈股动脉(cf PWV);进行治疗前后中医证候评分;检测治疗前后一氧化氮(NO),内皮素-1(ET-1),血管性血友病因子(v WF)和P-选择素等血管内皮损伤循环标志物。结果:治疗后联合组血压疗效总有效率为95.89%,高于西医组的86.49%(P0.05);治疗后联合组血压达标率为68.49%,高于西医组的51.35%(P0.05);治疗后联合组SBP,DBP水平均低于西医组,中医证候评分低于西医组(P0.01);治疗后联合组FMD高于西医组(P0.01),ba PWV和cf PWV低于西医组(P0.01);治疗后联合组ET-1,v WF和P-选择素水平均低于西医组,NO水平高于西医组(P0.01)。结论:松龄血脉康胶囊联合杞菊地黄丸治疗老年高血压患者能进一步的控制血压水平,改善肝肾亏虚,兼血瘀证症状,提高血压的达标率,并能改善血管内皮功能,有利于降低心脑血管疾病发生的风险。

Effects of Songling Xuemaikang Capsule Combined with Qiju Dihuang Pill on Vascular Endothelial Function in Patients with Elderly Hypertension with Deficiency of Liver and Kidney and Internal Static Blood Obstruction

Objective: To discuss the clinical efficacy of Songling Xuemaikang capsule combined with Qiju Dihuang pill in treating elderly hypertension(deficiency of liver and kidney and internal static blood obstruction) and investigate its effects on vascular endothelial function. Method: One hundred and forty-seven patients were randomly divided into western medicine group(74 cases) and combination group(73 cases) by random number table. Patients in western medicine group took felodipine sustained release tablets, 5-10 mg/time, 1 time/day, losartan potassium and hydrochlorothiazide tablets, 1 tablet/time, 1 time/day. Based on the treatment in western medicine group, patients in combination group added Songling Xuemaikang capsule(2 capsules/time, 3 times/day) combined with Qiju Dihuang pill(9 g/time, 2 times/day). The treatment course was 12 weeks for both groups. Before and after treatment, levels of blood pressure were detected to calculate the blood pressure compliance rate, flow-mediated dilation(FMD) was assessed by color doppler ultrasound diagnostic system in brachial artery both before and after treatment; pulse wave velocity(PWV) including brachial-ankle pulse wave velocity(baPWV) and carotid-femoral artery PWV(cfPWV) was detected by automatic arteriosclerosis detector both before and after treatment,traditional Chinese medicine(TCM) syndrome scores were graded, levels of nitric oxide(NO), endothelin-1(ET-1), von Willebrand factor(vWF) and P-selectin were also detected both before and after treatment. Result: The total effective rate for blood pressure in combination group was 95.89% after treatment, higher than 86.49%in western medicine group(P<0.05). Blood pressure compliance rate was 68.49% in combination group higher than 51.35%in western medicine group(P<0.05). After treatment, levels of SBP, DBP, baPWV, cfPWV, ET-1, vWF and P-selectin and TCM syndrome scores in combination group were lower than those in western medicine group(P<0.01), and levels of FMD and NO were higher than those in western medicine group(P<0.01). Conclusion: Songling Xuemaikang capsule combined with Qiju Dihuang pill can control blood pressure level, ameliorate the symptoms of liver and kidney deficiency and blood stasis, improve vascular endothelial function, and reduce the risk of cardiovascular diseases in treatment of elderly hypertension.