甲氯噻嗪片治疗轻中度原发性高血压的疗效和安全性

目的：观察甲氯噻嗪片治疗轻、中度原发性高血压的降压效果和安全性。方法：门诊轻、中度原发性高血压病人，随机分为甲氯噻嗪组和氢氯噻嗪组，每组各24例，分别服甲氯噻嗪2．5mg或氢氯噻嗪25mg，qd，治疗4周后舒张压≥90mmHg者剂量加倍，疗程8周。服药后每2周随访1次，测定血压和心率。治疗前后测定血、尿常规，血生化指标及心电图，并监测血钾，必要时口服补钾。结果：服药第2、4、6、8周末两组血压均较治疗前降低（P〈0．01）；治疗8周后与治疗前比较，甲氯噻嗪组和氢氯噻嗪组收缩压／舒张压（SBP／DBP）分别下降（16．0±7．9）／（15．7±5．2）mmHg和（17．2±6．4）／（16．2±5．0）mmHg；组间下降值无统计学差异；降压总有效率分别为87．5％和83．3％（P〉0．05）。两组治疗前后心率均无明显变化，不良反应轻微，出现较多的是头痛、头晕。甲氯噻嗪组和氢氯噻嗪组分别于用药4周后出现低血钾2例和1例，补钾后恢复正常。其余实验室指标无明显改变。结论：甲氯噻嗪片治疗轻、中度原发性高血压安全、有效。

The efficacy and safety of methyclothiazide tablets in treatment of patients with mild-to-moderate essential hypertension

Objective： To evaluate the effectiveness and safety of methyclothiazide tablets in treatment of patients with mild-to-moderate essential hypertension. Methods： The outpatients with mild-to-moderate essential hypertension were randomly assigned to receive methyclothiazide （2.5 mg/d,n=24） or hydrochlorothiazide（25 mg/d, n= 24） for 8 weeks. Blood pressure and heart rate were measured every 2 weeks. The dosage was doubled if diastolic blood pressure （DBP） was higher than 90 mmHg at the end of week 4. The routine analyses of blood and urine, biochemistry and electrocardiography examinations were performed before and after treatment. The concentration of blood potassium was monitored, and potassium chloride was orally given to the patients whenever hypokalemia appeared. Results： Blood pressure decreased significantly after treatment for 2,4,6 and 8 weeks （P 〈 0. 01 ）. Systolic blood pressure （SBP）/DBP decreased by （ 16.0 4- 7.9 ） / （ 15.7 4± 5.2） mmHg and （17.2 ± 6.4） / （16.2 4± 5.0） mmHg after treatment for 8 weeks in methyclothiazide and hydrochlorothiazide groups, respectively. There was no statistical difference between the 2 groups. The effective rate was 87.5% in methyclothiazide group and 83.3% in hydrochlorothiazide group（P〉0.05）. No change in heart rate before and after treatment was observed. Adverse drug reactions were mild, such as headache and dizziness. There were two and one patients with mild hypokalemia after treatment for 4 weeks in methyclothiazide and hydrochlorothiazide group,respectively. The blood potassium of the patients recovered normal after giving potassium chloride orally. There was no significant change in other laboratory indexes. Conclusion：Methyclothiazide was proved to be a safe and effective medication in treatment of patients with mild-to-moderate essential hypertension.