甘酸缓急中药组方治疗肝阳上亢型H型高血压疗效及对血压变异性、同型半胱氨酸的影响

目的观察甘酸缓急中药组方治疗肝阳上亢型H型高血压患者临床疗效及对血压变异性和血清同型半胱氨酸水平的影响。方法将2016年1月—2017年12月在沧州中西医结合医院诊治的120例轻中度高血压患者随机分为2组,西药组60例给予苯磺酸氨氯地平片(必要时联合马来酸依那普利片)、叶酸片治疗,联合组60例在西药组治疗基础上加用甘酸缓急中药口服,2组疗程均为4周。统计2组患者治疗后中医证候疗效、诊室血压疗效,观察2组治疗前后24 h动态血压、血压变异性指标及血清同型半胱氨酸水平变化。结果治疗4周后,联合组中医证候疗效总有效率为100%(60/60),诊室血压疗效总有效率为98.3%(59/60),西药组分别为78.3%(47/60)和90.0%(54/60),联合组均明显高于对照组(P均<0.05)。治疗后2组动态血压、血压变异性指标及血清同型半胱氨酸水平均较治疗前明显降低(P均<0.05),且联合组24 h收缩压、24 h舒张压、夜间收缩压、夜间舒张压及血压变异性各指标均明显低于西药组(P均<0.05),2组白昼收缩压、白昼舒张压和血清同型半胱氨酸水平比较差异均无统计学意义(P均>0.05)。结论在西医治疗基础上加用甘酸缓急中药能够更好地改善肝阳上亢型H型高血压患者临床症状,可更明显降低诊室血压、动态血压及血压变异性。

Efficacy of the decoction made with sour and sweet Chinese herb for relieving urgency on type H hypertension of pattern of liver Yang hyperactivity and its influence on blood pressure variability and homocysteine

Objective It is to observe the clinical curative effect of the decoction made with sour and sweet Chinese herb for relieving urgency on type H hypertension of pattern of liver Yang hyperactivity and its influence on blood pressure variability and the level of serum homocysteine.Methods 120 patients with mild to moderate hypertension diagnosed and treated in Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2016 to December 2017 were randomly divided into 2 groups.60 patients in the western medicine group were treated with amlodipine besylate tablets(combined with enalapril maleate tablets if necessary)and folic acid tablets,60 cases in the combined group were treated with the decoction made with sour and sweet Chinese herb for relieving urgency by oral administration on the basis of the western medicine group.The treatment course of the two groups was 4 weeks.The curative effect of TCM syndromes and blood pressure in the treatment room of the patients in the two groups were counted.The changes of 24 h ambulatory blood pressure,blood pressure variability indexes and serum homocysteine levels before and after treatment in the two groups were observed.Results After 4 weeks of treatment,the total effective rate of TCM syndrome curative effect was 100%(60/60),and the total effective rate of clinical blood pressure curative effect was 98.3%(59/60)in the combined group,and the rates in the western medicine group were 78.3%(47/60)and 90.0%(54/60)respectively,the rates in the combination group was significantly higher than those in the control group(all P<0.05).After treatment,the ambulatory blood pressure,blood pressure variability index and serum homocysteine level of the two groups were significantly lower than those before treatment(P<0.05),and the 24 h systolic blood pressure,24 h diastolic blood pressure,night systolic blood pressure,night diastolic blood pressure and the indexes of blood pressure variability in the combination group were significantly lower than those in the western medicine group(all P<0.05).There was no significant difference in the level of diurnal systolic blood pressure,diastolic blood pressure and serum homocysteine between the two groups(all P>0.05).Conclusion The decoction made with sour and sweet Chinese herb for relieving urgency based on western medicine can more effectively improve the clinical symptoms of H-type hypertension patients with syndrome of liver Yang hyperactivity,and can more significantly reduce the blood pressure in the treatment room,ambulatory blood pressure and blood pressure variability.