复方七芍降压片合替米沙坦治疗高血压左心室肥厚肝肾阴虚、瘀血生风证及改善舒张功能的临床观察

目的观察复方七芍降压片干预高血压左心室肥厚（肝肾阴虚、瘀血生风证）的疗效。方法采用随机对照方法分为观察组（43例）和对照组（43例）,两组均予相同的西医基础治疗,观察组加用复方七芍降压片治疗,疗程为24周。观察两组患者治疗前后血压、中医证候积分、超声心动图,检测血浆血管紧张素Ⅱ（AngII）、醛固酮（ALD）指标。结果与治疗前比较,治疗后两组患者血压值均有明显改善（P〈0.05）;治疗后观察组的中医证候疗效总有效率明显高于对照组（P〈0.01）;室间隔厚度（IVST）、左室后壁厚度（IVPWT）、左室重量指数（LVMI）均较治疗前有明显降低（P〈0.05）,观察组明显优于对照组（P〈0.05）;两组治疗前后左心室舒张功能指标的比较,观察组二尖瓣舒张早期最大峰值速度/舒张晚期最大峰值速度（E/A）、等容舒张时间（IVRT）、E峰减速时间（EDT）均较治疗前有明显升高（P〈0.05）;两组治疗后血浆AngⅡ、ALD水平与治疗前比较均明显降低（P〈0.05）,且观察组AngⅡ、ALD水平明显低于对照组（P〈0.05）。结论复方七芍降压片联合替米沙坦治疗,可有效减少高血压左心室肥厚（肝肾阴虚、瘀血生风证）患者的中医证候积分,逆转左心室肥厚,并改善左心室舒张功能。

Clinical Observation on Compound Qishao Jiangya Tablets Combined Telmisartan in Treating Hypertensive Left Ventricular Hypertrophy of Yin Deficiency of Liver and Kidney,Blood Stasis Causing Wind and Improving Diastolic Function

Objective To observe the effects of compound Qishao Jiangya tablets intervention of hypertensive left ventricular hypertrophy（yin deficiency of liver and kidney, blood stasis causing wind） effect. Methods The patients were randomly divided into the observation group（43 cases）and the control group（43 cases）, two groups were treated with the same basic treatment and the observation group was added with compound Qishao Jiangya tablets for 12 weeks.The hypertension, TCM syndrome integral, ultrasonic cardiogram angiotensin II（AngII） and aldosterone（ALD） indexes of both groups were observed before and after treatment.Results After12 weeks treatment, the blood pressure of all patients was significantly improved（P〈0.05）.The therapeutic effect of the observation group was significantly higher than the control group（P〈0.01）;the observation group interventricular septal thickness（IVST）, left ventricular posterior wall thickness（IVPWT）, left ventricular mass index（LVMI） significantly decreased than before treatment（P〈0.05）, the observation group was significantly better than the control group（P〈0.05）,the two groups before and after treatment of end diastolic left ventricular diameter（LVDd）showed no significant differences（P〈0.05）; comparing the left ventricular diastolic function indexe before and after treatment between the two groups, the observation group mitral diastolicpeak velocity of early（E） and late diastolic peak velocity（E/A）, isovolumic relaxation time（IVRT）, E peak deceleration time（EDT） were significantly increased after treatment（P〈0.05）, the E/A, IVRT is better than those of the control group（P〈0.05）; the two groups＇ s Ang Ⅱ and ALD levels were significantly decreased after 12 weeks treatment（P〈0.05）, and the Ang II and ALD levels of the observation group were significantly lower than those of the control group（P〈0.05）. Conclusion Compound Qishao Jiangya tablets combined with telmisartan can effective