中西医结合治疗肝火亢盛型高血压病30例临床观察

目的：观察中西医结合治疗肝火亢盛型高血压病患者血压、证候和血浆内皮素的影响。方法：60例患者随机分为两组：治疗组30例,以中药清泄肝火、化瘀利水剂加硝苯地平缓释片治疗,完成30例;对照组入选30例,以依那普利片和硝苯地平缓释片治疗,完成26例。疗程2-4周。观察治疗前后血压、证候疗效、血浆内皮素变化。结果：①对降压疗效的影响：治疗组显效12例,有效10例,无效8例,愈显率40.00%;对照组显效11例,有效9例,无效6例,愈显率42.31%,两组比较无明显差异。②治疗前后血压的变化：两组治疗后患者的血压水平较治疗前均显著降低（P〈0.01）,治疗前、治疗后治疗组与对照组的收缩压及舒张压比较,无显著性差异。③对证候疗效的影响：治疗组显效17例,有效7例,无效6例,愈显率56.67%;对照组显效7例,有效10例,无效9例,愈显率26.92%,治疗组证候疗效优于对照组（P〈0.05）。④对血浆内皮素的影响：治疗组治疗后血浆内皮素水平明显下降（P〈0.05）,对照组血浆内皮素治疗前后无明显差异。⑤对安全性的影响：治疗组30例全部完成治疗疗程,对照组30例中4例出现咽痒干咳,中途退出,实际完成26例,两组病例血尿粪常规、肝肾功能及心电图检查均未发现有毒副作用。结论：中西医结合治疗有降低血压的疗效,能够改善或缓解肝火亢盛证证候的作用,具有降低血浆内皮素的作用,在治疗肝火亢盛型高血压病中特色明显。

Clinical Observation on Treatment of Hypertension of Liver-fire Hyperactivity Type with Integrated Chinese and Western Medicine

Objective： To observe the effect of integrated Ch inese and Western medicine on blood pressure, syndromes and plasma endothelin of patients with hypertension of liver-fire hyperactivity type. Methods： 60 patie nts were randomly divided into two groups： treatment group （30 cases） and contro l group （30 cases）, the former were treated by Chinese drugs with the function o f removing liver-fire and removing blood stasis and inducing diuresis plus Nife dipine Release-controlled Tablets, 30 cases completed; the latter were treated with Enalapril Tablets and Nifedipine release-controlled Tablets, 26 cases comp leted. The treatment course was 2-4 weeks. The changes of blood pressure, syndro mes and plasma endothelin were observed before and after the treatment. Results： ① The effect on antihypertensive effects： in the treatment group, 12 cases sho wed effect, 10 cases had effect, 8 cases had no effect, the effective rate was 4 0.00%; in the control group, 11 cases showed effect, 9 cases had effect, 6 cases had no effect, the effective rate was 42.31%, there was no significant differen ce between the two groups. ② Changes in blood pressure before and after the tre atment： blood pressure levels of two groups after the treatment were significan tly lower than those before the treatment （P〈0.01）, there was no significant differences in systolic and diastolic blood pressure of two groups before and a fter the treatment. ③The effect on syndrome effects： in the treatment group, 17 cases showed effect, 7 cases had effect, 6 cases had no effect, the effective r ate was 56.67%; in the control group, 7 cases showed effect, 10 cases had effect , 9 cases had no effect, the effective rate was 26.92%, the syndrome effect of t he treatment group was superior to that of the control group（P〈0.05）. ④The effect on plasma endothelin： plasma endothelin levels of the treatment were sign ificantly decreased after the treatment （P〈0.05）, while there was no signifi cant difference in the plasma endothelin levels of the control group before and after the treatment. ⑤The effect on security： 30 patients of the treatment grou p completed the treatment course, 26 cases of 30 in the control group completed the treatment course. No toxic side effects were found as to hematuria, stool, l iver and kidney function and ECG of two groups. Conclusion： The integrated Chine se and Western medicine has the functions of lowering blood pressure, improving or alleviating liver-fire hyperactivity, reducing the level of endothelin.