非洛地平缓释片治疗原发性高血压临床观察

目的 观察非洛地平缓释片单独治疗各级原发性高血压的降压疗效.方法 对门诊各级原发性高血压患者60例,口服非洛地平缓释片5mg/d.分别与服药后3d、1周、2周、3周和4周观察血压,血压降至140/90mmHg或以下为有效.结果 ①非洛地平缓释片单独治疗3d有效率为51.6%,1周治疗有效率为61.7%,2周治疗有效率为68.3%,3周治疗有效率为71.6%,4周治疗有效率为71.6%;②治疗前后血糖、血脂比较,两组间差异无显著性,p>0.05.③不良反应小而轻微.结论 非洛地平缓释片是一种较为理想、安全的长效降压药物.     

非洛地平联合倍他乐克治疗中老年高血压病临床观察

目的：观察非洛地平联合倍他乐克治疗中老年高血压的疗效。方法对100例高血压患者采取单独和联合两种不同治疗方法,连续用药8w观察治疗前后降压情况、副作用和实验室变化。结果非洛地平联合倍他乐克治疗高血压疗效优于单独用药组,而且副作用少,耐受性好。结论联合应用非洛地平和倍他乐克治疗中老年高血压观察组疗效明显高于对照组,既可减少药量,减少副作用,又可增加降压效应。     

冠心舒通胶囊联合酒石酸美托洛尔胶囊治疗不稳定型心绞痛的临床观察

目的:探讨冠心舒通胶囊联合酒石酸美托洛尔胶囊治疗不稳定型心绞痛(UA)的效果.方法:选取2018年7月2020年8月就诊于本院的78例UA患者作为研究对象.采用随机数字表法分为对照组和观察组,各39例.对照组采用酒石酸美托洛尔胶囊治疗,观察组采用冠心舒通胶囊联合酒石酸美托洛尔胶囊治疗,两组均治疗8 w.分析比较两组的中医证候评分、心绞痛发作情况(发作次数与发作持续时间)及血液流变学指标[纤维蛋白原(FIB)、血浆粘度(PV)和血小板聚集率(PAR)].结果:治疗8w后,两组中医证候评分均较治疗前显著降低,且观察组中医证候评分比对照组更低(P<0.05).治疗8w后,两组心绞痛发作次数均显著减少,心绞痛发作持续时间均显著缩短,且观察组心绞痛发作次数更少,心绞痛发作持续时间更短(P<0.05).治疗8 w后,两组FIB、PV和PAR水平均显著降低,且观察组FIB、PV和PAR水平更低(P<0.05).结论:UA患者采用冠心舒通胶囊联合酒石酸美托洛尔胶囊治疗,可促进心肌血液微循环,缓解临床症状,降低心绞痛发作频率.     

稳心颗粒联合美托洛尔治疗86例冠心病心律失常疗效观察

目的：探讨稳心颗粒联合美托洛尔治疗冠心病心律失常的临床疗效。方法根据患者的就诊顺序，将选取的86例患者分为单一组和联合组，各43例，单一组给予美托洛尔进行治疗，联合组给予稳心颗粒联合美托洛尔进行治疗，对比观察两组的临床效果。结果联合组临床总有效率为95.34%，单一组为69.76%，两组临床总有效率差异性显著，具有统计学意义(<0.05)。结论在冠心病心律失常治疗中，相较于美托洛尔单独治疗，稳心颗粒联合美托洛尔治疗具有更加显著的实效。     

美托洛尔联合依那普利对高血压性心脏病患者心功能及QT间期离散度的影响

目的:探讨高血压性心脏病(HHD)患者采用美托洛尔与依那普利联合治疗的效果,旨在为临床治疗HHD提供参考依据.方法:选取2017年12月-2018年12月我院收治的HHD患者80例作为研究对象.依据掷硬币法将患者分为对照组和观察组,每组各40例.对照组给予依那普利治疗,观察组在对照组基础上增用美托洛尔治疗.分析对比两组临床疗效、心功能、QT间期离散度(QTd).结果:观察组临床有效率显著高于对照组,LVEDV、LVESV水平显著低于对照组,EF水平、E/A值显著高于对照组(P<0.05).观察组治疗3 m、6 m、12 m,QTd均显著低于对照组(P<0.05).结论:依那普利联合美托洛尔治疗HHD患者,可提高临床疗效,改善患者心功能、缩小QT间期离散度.     

硝苯地平缓释片联合依那普利治疗原发性高血压病疗效分析

目的 评价硝苯地平缓释片联合依那普利治疗原发性高血压病的疗效.方法选取原发性高血压病患者180例,随机分为治疗组(依那普利联合硝苯地平缓释片组),和对照A组(硝苯地平缓释片组)及对照B组(依那普利组),每组60例患者,疗程均为8周,观察临床疗效及不良反应.结果 治疗组与对照组患者的血压均有所下降,治疗组血压下降明显,总有效率为91.7%,对照A组及B组的总有效率分别为76.7%、68.3%.治疗组与对照组相比差异有统计学意义(P<0.05).结论 硝苯地平缓释片联合依那普利治疗原发性高血压病疗确切且显著.     

依那普利联合美托洛尔治疗充血性心力衰竭的远期疗效研究

目的了解依那普利联合美托洛尔对充血性心力衰竭(CHF)的远期疗效.方法 82例CHF患者,分为2组,研究组42例,使用依那普利联合美托洛尔治疗,疗程24个月;对照组40例,使用常规治疗,比较两组的疗效及超声心动图变化.结果研究组治疗2年的总有效率90.5%,明显高于对照组47.5%(p<0.05),心功能持续性改善,死亡率较常规治疗组明显降低(p<0.05).结论依那普利联合美托洛尔不仅持续改善心衰症状,提高生活质素,还能明显降低远期病死率.     

丙戊酸镁缓释片对难治性抑郁症的辅助治疗

目的 探讨丙戊酸镁缓释片对难治性抑郁症的辅助疗效及安全性.方法 将60例难治性抑郁症患者随机分成研究组和对照组各30例,研究组采用丙戊酸镁缓释片联合盐酸帕罗西汀治疗并与单独采用盐酸帕罗西汀治疗的对照组进行对照,分别在治疗1、2、4、6、8周以汉密尔顿抑郁量表(HAMD)评定疗效,以副反应量表(TESS)评定不良反应.结果 两组HAMD评分在治疗后与治疗前比较均有显著差异性(P＜0.01),两组间HAMD评分在治疗后第4、6、8周有显著差异性(t=2.67,2.75,2.15；P＜0.01).两组间副反应量表评分差异不明显.结论 丙戊酸镁缓释片联合盐酸帕罗西汀治疗难治性抑郁症效果好于单独采用盐酸帕罗西汀,且耐受性好.     

芪红汤联合美托洛尔治疗冠心病合并慢性心力衰竭患者的临床疗效观察

目的 观察芪红汤联合美托洛尔治疗冠心病合并慢性心力衰竭患者的临床疗效.方法 选取2018年5月～2020年10月我院收治的90例冠心病合并慢性心力衰竭患者作为研究对象,根据治疗方法不同分为对照组(美托洛尔治疗)和实验组(芪红汤联合美托洛尔治疗),每组各45例.比较两组患者的临床疗效、心功能改善情况及不良反应发生率.结果...     

沙库巴曲缬沙坦联合琥珀酸美托洛尔缓释片治疗冠心病合并慢性心力衰竭的临床效果评价

目的:分析沙库巴曲缬沙坦联合琥珀酸美托洛尔缓释片治疗冠心病合并慢性心力衰竭的临床效果.方法:选取2019年1月至2020年1月本院收治的108例冠心病合并慢性心力衰竭患者作为研究对象.根据治疗用药不同将患者分为对照组(n=52)和观察组(n=56).对照组口服琥珀酸美托洛尔缓释片,观察组在对照组用药基础上增加口服沙库巴曲缬沙坦钠片.对比两组心功能指标、血清生化指标、6min步行实验(6 min walking test,6MWT)和不良反应.结果:治疗后左侧卧位时每搏输出量(Stroke output in left decubitus position,SV)、左室射血分数(Left ventricular ejection fraction,LVEF)上升,左室收缩末内径(Left ventricular end systolic diameter,LVESD)、左室舒张末内径(Left ventricular end diastolic diameter,LVEDD)降低,而观察组SV、LVEF高于对照组,LVESD、LVEDD则低于对照组(P<0.05);治疗后氨基末端脑钠肽(Amino terminal brain natriuretic peptide,NT-BNP)、心肌肌钙蛋白I(Cardiac troponin I,cTnI)低于治疗前,6MWT长于治疗前,而观察组NT-BNP、cTnI低于对照组,6MWT明显长于对照组(P<0.05);治疗后两组不良反无差异(P>0.05).结论:沙库巴曲缬沙坦联合琥珀酸美托洛尔缓释片治疗冠心病合并慢性心力衰竭相比单一治疗效果更为理想.     

厄贝沙坦联合美托洛尔治疗慢性充血性心衰的疗效观察

目的 观察厄贝沙坦联合美托洛尔治疗慢性充血性心衰的临床疗效。方法 选择我院自2015年3月~2016年5月收治68例慢性充血性心衰患者作为研究对象,将其随机分成对照组和研究组,每组34例。对照组采用厄贝沙坦治疗,研究组采用厄贝沙坦联合美托洛尔治疗,比较两组患者治疗前后的心率（HR）、收缩压（SBP）和舒张压（DBP）等血压水平以及左室舒张末内径（LVEDd）、左室收缩末内径（LVESd）和左室射血分数（LVEF）等左心功能指标,并统计和计算两组患者治疗期间的不良反应发生率及治疗的总有效率。结果 两组患者治疗前的心率、血压及各项左心功能水平对比,差异均无统计学意义（P＞0.05）。治疗期间,研究组与对照组的不良反应发生率对比差异统计学意义（P＞0.05）。治疗后,研究组的HR、DBP、DBP、LVEDd、LVESd均明显低于对照组,研究组的LVEF、治疗的总有效率明显高于对照组,两组对比差异有统计学意义（P＜0.05）。结论 对慢性充血性心衰患者采用厄贝沙坦联合美托洛尔治疗,不仅能有效改善患者的心率和血压水平,同时还能有效促进患者的左心功能恢复,患者治疗期间的毒副反应发生率较低,因此其是一组安全、高效的组合治疗药物。     

Home relaxation techniques for essential hypertension

A 10-week relaxation treatment focused on home practice and self-monitoring of blood pressure for the purpose of lowering blood pressure in patients with essential hypertension. Comparisons were made among relaxation (n = 13), relaxation in combination with electromyographic biofeedback (n = 14), and a control condition in which patients simply monitored their blood pressure (n = 14). These three groups of patients, all of which received antihypertensive medication, were compared with a fourth group that practiced relaxation without drug therapy (n = 17). Relaxation and relaxation/biofeedback were equally effective in reducing blood pressure recorded at home in the morning and evening and produced greater decreases than in the control group. Relaxation without drugs, although somewhat more effective than self-monitoring, did not reduce blood pressure as much as the two conditions in which medication was combined with relaxation. Although reductions over the course of treatment were noted in blood pressure recorded in the laboratory, the four treatment conditions did not differ significantly from one another.     

A controlled study of a standardized behavioral stepped treatment for hypertension

A standardized behavioral stepped care (SC) treatment for hypertension (blood pressure monitoring followed by self-administered systolic blood pressure biofeedback and relaxation, in sequence, as needed) was administered to 51 patients whose blood pressures were medically controlled to within normal limits. The effects of treatment upon blood pressure, medication requirements, and cost of care were compared with those of 51 referred care (RC) control patients who continued their usual care for hypertension. SC and RC patients were matched in groups on the basis of medication requirements (Group I, diuretics; Group II, beta-blockers alone or with a diuretic; and Group III, vasodilators alone or with a drug from Group I or II). The duration of the SC procedure was 1, 4, or 7 months--as necessary--and the follow-up period was 12 months. The RC protocol lasted 19 months. Medication requirements for SC patients declined to levels significantly (p less than 0.05) lower than those of RC patients from the biofeedback phase throughout follow-up for all drug groups combined. However, when the drug groups were analyzed separately, this was true for Groups I and II only. Similarly, the cost of care for all drug groups combined was lower for SC patients from the biofeedback phase through 9 months of follow-up, also reflecting changes seen in Drug Groups I and II only. Blood pressure levels remained controlled, in all groups, throughout the investigation. Clinical possibilities for combined behavioral and pharmacological treatment of hypertension are discussed relative to the pathophysiology of hypertension, and questions for future research are suggested.     

曲美他嗪联合琥珀酸美托洛尔治疗冠心病心力衰竭疗效观察

目的 观察冠心病心力衰竭患者施予曲美他嗪与琥珀酸美托洛尔联合治疗的效果。方法 将本院收治的120例冠心病心力衰竭患者随机分为A组与B组,各60例。A组行常规治疗,B组在A组基础上施予曲美他嗪与琥珀酸美托洛尔联合治疗,比较两组的临床疗效及治疗前后患者的心肌功能情况。结果 治疗后B组患者LVEDD、LVESD、DBF、SBF低于A组,LVEF高于A组,差异有统计学意义（P＜0.05）;A组总有效率为81.67%,低于B组的96.67%,差异有统计学意义（P＜0.05）。结论 曲美他嗪与琥珀酸美托洛尔联合治疗冠心病心力衰竭,临床效果显著,可有效改善患者心肌功能。     

两种β受体阻滞剂治疗慢性心衰的临床疗效及球结膜微循环观察

目的:对比观察比索洛尔,美托洛尔治疗慢性心力衰竭的疗效和安全性。方法:206例慢性心衰患者随机分为比索洛尔组(94例)和美托洛尔组(112例),应用彩色超声心动图测量患者治疗前和后6个月、12个月,射血分数、左室腔径变化,并观察患者心率(HR)、血压(BP)、6分钟步行距离(6-MWD)及球结膜微循环管经、血管面积的变化。结果:两组治疗前、后心功能均有改善,但比索洛尔组比美托洛尔组明显。与治疗前相比,两组治疗后6个月、12个月,随时间的增加,心腔内径明显缩小,HR、BP明显下降,两组治疗后6个月,6分钟步行距离较前延长(P<0.05),12个月明显延长(P<0.001),比索洛尔比美托洛尔更显著。两组球结膜微血管的管径均较用药前增粗、血管面积均较用药前增加,血色较前改善。结论:比索洛尔、美托洛尔对慢性心衰的治疗效果是肯定和安全的。     

Functional and biochemical analyses of isolated rat hearts in renal and reversed renal hypertension

The present study evaluates cardiac function, plasma renin activity (PRA) and left ventricular (LV) myosin isoenzymes in untreated two-kidney, one-clip Goldblatt hypertensive rats (2KIC) and in 2KIC treated with felodipine and metoprolol. Normotensive rats (NCR) and another group of 2KIC, in which the renal artery constriction was removed (UC-2KIC), were also investigated. Cardiac performance was assessed by means of a working heart perfusion device, allowing also for measurements of myocardial oxygen consumption. Following antihypertensive therapy and unclipping, blood pressure became close to normotensive levels. PRA remained equally elevated in treated and untreated 2KIC, but became practically normalized after unclipping. Relative LV weight in 2KIC increased 74% above that in NCR but in treated 2KIC increased by only 20%. In UC-2KIC LV hypertrophy became reversed, LV weight/body being about the same as in treated 2KIC. In treated 2KIC, coronary resistance at maximal dilatation was significantly reduced, implying prevention of hypertensive, structural coronary vascular changes, and optimal LV function was improved markedly in the lower range of perfusion pressures compared with untreated 2KIC. When, however, the hearts were challenged at a high pumping resistance (perfusion pressure), LV function was similar in untreated and treated 2KIC. Myocardial oxygen consumption for given levels of stroke work was significantly lower in treated than in untreated 2KIC. The myosin isoenzyme pattern in the LV of 2KIC was shifted, with significantly higher amounts of VM-3 than in NCR. This shift was normalized by antihypertensive therapy or by unclipping. In conclusion, antihypertensive therapy with felodipine and metoprolol prevents the development of coronary vascular and left ventricular hypertrophy in 2KIC. This may contribute to enhance cardiac performance at low aortic pressure. The lack of improvement in optimal cardiac performance (at high aortic pressure) implies that the hypertensive state per se, rather than extent of pressure elevation, cardiac hypertrophy, or changes of LV isoenzymes, determines the reduced cardiac function in renal hypertensive rats (Friberg & Nordborg 1986).     

酒石酸布托啡诺、氟比洛芬酯、芬太尼联合异丙酚镇痛镇静对ICU内机械通气患者的疗效比较

目的 研究ICU内机械通气患者酒石酸布托啡诺、氟比洛芬酯、芬太尼联合异丙酚镇痛镇静疗效比较。方法 选取2015年5月~2017年5月在我院ICU病房接受机械通气治疗的135例患者,将患者随机分三组,各组45例,A组酒石酸布托啡诺+异丙酚,B组氟比洛芬酯+异丙酚,C组芬太尼+异丙酚,比较组间生命体征指标及镇痛、镇静评分。结果 A、B组用药后1 h及2 h的HR、RR、MAP均比C组低(P＜0.05);A组FPS评分、Ramsay评分分较B组、C组低,差异有统计学意义(P＜0.05)。结论 联合应用酒石酸布托啡诺、异丙酚可有效稳定ICU机械通气患者生命体体征。     

Antihypertensive effects at rest and during exercise of a calcium blocker, nifedipine, alone and in combination with metoprolol

The effects of metoprolol and/or nifedipine on blood pressure were studied in 12 hypertensive males at rest and during standardized exercise on an ergometer bicycle. Metoprolol (100 mg X 2) and nifedipine (10 mg X 3) gave similar blood pressure reductions both at rest and during exercise. When the drugs were combined, the antihypertensive effect was potentiated. The PQ interval was not affected during any treatment period. No adverse reactions to the combined treatment were noted. The combination of a calcium blocker with vasodilating properties with a beta-blocker, which reduces cardiac output, thus seems a logical and promising therapeutic approach in the treatment of hypertension.     

The effects of acebutolol and metoprolol on walking distances and distal blood pressure in hypertensive patients with intermittent claudication

The effects of acebutolol (with intrinsic sympathomimetic activity (ISA] and metoprolol (without ISA) on arm blood pressure, ankle systolic blood pressure, claudication distances (CD) and maximal walking distances (MWD) were compared in patients with essential hypertension and intermittent claudication. Fourteen patients participated in a long-term, open, randomized cross-over study. After randomization the patients received either acebutolol, 200 mg b.i.d., or metoprolol, 100 mg b.i.d. After eight weeks the drugs were shifted and after another eight weeks they were withdrawn. Arm and ankle blood pressure, CD and MWD were determined before randomization and after 4, 8, 12 and 16 weeks, and again 4-6 weeks after withdrawal of the drugs. The arm blood pressure was reduced by 20/13 mmHg after acebutolol and by 22/21 mmHg after metoprolol. In spite of a significant decrease in arm blood pressure there were no significant changes in ankle blood pressure, CD or MWD after the two drugs. After withdrawal of the drugs and after the arm blood pressure had returned to the control value no significant changes were seen in CD, MWD or ankle blood pressure. It is concluded that beta-blockers have no deleterious effect on CD, MWD or ankle blood pressure in patients with hypertension and intermittent claudication. No effect of ISA was demonstrated.     

认知行为治疗对抑郁症患者的疗效及生活质量的影响

目的探讨药物合并认知行为治疗对抑郁症患者的疗效及生活质量的影响。方法将72例抑郁症患者随机分为药物合并认知行为治疗组与药物治疗组,治疗观察8周。于治疗前及治疗2、4、8周末采用汉密尔顿抑郁量表(HAM D-24)、临床疗效总评量表(CG I)与副反应量表(TESS)分别评定疗效与不良反应。于治疗前及治疗8周末采用生活质量综合评定问卷(GQOL-74)评定患者生活质量。结果①治疗8周末两组HAM D评分有显著性差异(t=5.12,P<0.01);②两组G I评分治疗6、8周末组间比较有显著性差异(t=2.22,2.65;P<0.05),E I评分治疗8周末组间比较有显著性差异(t=1.95,P<0.05);③研究组治疗8周末除物质生活维度外,其他3个维度评分与对照组比较均有显著性差异(t=2.24,3.34,2.46;P<0.05)。结论药物合并认知行为治疗可提高抑郁症的治疗效果和生活质量。