平肝抑眩膏辅助治疗肝阳上亢型高血压病的临床疗效观察

发布时间：2018-03-14 23:31

本文选题：高血压病　切入点：肝阳上亢　出处：《山西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:观察口服平肝抑眩膏联合苯磺酸左旋氨氯地平片治疗肝阳上亢型轻中度高血压病的临床疗效,观察其对高血压病患者临床症状、动态血压的影响,进一步探求中西医结合治疗该病的临床有效性、稳定性及安全性,为中西医结合防治该病提供相关临床依据。方法:本研究按照随机对照的原则,纳入肝阳上亢型轻中度高血压病患者60例,分为治疗组和对照组各30例。对照组给予口服苯磺酸左旋氨氯地平片(施慧达药业集团有限公司生产,批准文号:国药准字H19991083),用法为2.5mg每次,每日早晨7点空腹口服。治疗组在给予上述口服药物基础上加服平肝抑眩膏,本膏方为山西医科大学第二医院董联玲教授经验方,由女贞子玉竹100g,竹茹100g,麦冬150g,黄精150g,枸杞子150g,何首乌120g,山萸肉120g,桑椹120g,钩藤150g,白芍100g,丹参120g,远志100g,石菖蒲100g,柏子仁100g,西洋参100g,龟甲胶200g等组成。膏方的制作参照膏剂的传统加工工艺流程,由山西省中医药研究所制剂室制订,按照标准化、规范化操作,从而确保膏滋的质量和疗效。用法:餐后口服,20g/次,早晚分服,4周一疗程,两组同时治疗两个疗程。详细记录治疗前后两组患者安全性指标、证候指标及24小时动态血压数据[动态血压由用美国SP(a)celabs Medical公司生产的9027.ABP型动态血压记录仪(ABPM)监测],并对实验数据进行整理及统计分析。结果:1.疗效性评价:(1)从证候积分角度分析联合治疗组总有效率为96%,单纯西药组总有效率为83%。联合用药组症候改善效果明显优于对照组。(2)联合用药组总有效率为96%,高于单纯西药组,联合治疗降压幅度优于单纯西药组。(3)两组经治疗,动态血压变异性(Ambulatory blood pressure variability,ABPV,通常由血压变异系数CV来表示)及昼夜节律均改善,治疗组转为杓型血压百分比为41%,明显优于对照组的转为杓型百分比17%。2.安全性评价:两组患者治疗前后安全性指标经统计分析差异无统计学意义(P0.05),药物均安全。结论:1.平肝抑眩膏联合苯磺酸左旋氨氯地平片组治疗肝阳上亢型轻中度高血压病对比单纯口服苯磺酸左旋氨氯地平片组,降压效果更加显著、平稳,对于血压昼夜节律及血压变异性的改善程度更大,能更大程度降低心脑血管疾病发生风险。2.试验过程中未发现肝肾功能损伤等安全性问题,治疗药物安全可靠。
[Abstract]:Objective: to observe the clinical effect of oral Pinggan Yixuan ointment combined with levamlodipine benzenesulfonic acid tablets in the treatment of mild and moderate hypertension with hyperactivity of liver-yang, and to observe its effect on clinical symptoms and ambulatory blood pressure of patients with hypertension. To further explore the clinical efficacy, stability and safety of integrated traditional Chinese and western medicine in the treatment of the disease, to provide the relevant clinical basis for the prevention and treatment of the disease. Methods: according to the principle of random control, Sixty patients with liver-yang hyperactivity type mild and moderate hypertension were divided into treatment group (n = 30) and control group (n = 30). The control group was treated with oral L-amlodipine benzenesulfonic acid tablets (produced by Shwe Huida Pharmaceutical Group Co., Ltd.). Approval symbol: Chinese medicine standard H19991083, used 2.5mg every time, every morning at 7 o'clock empty stomach. Treatment group on the basis of the above oral drugs plus Pinggan Yixuan ointment, this paste prescription is Professor Dong Lianling of Shanxi Medical University, It is composed of Ligustrum lucidum 100g, bamboo Ru 100g, wheat winter 150g, yellow essence 150g, medlar 150g, Polygonum multiflorum 120g, cornwood 120g, mulberry 120g, hookwood 150g, white peony 100g, salvia miltiorrhiza 120g, Yuanqi 100g, calamus 100g, cypress seed 100g, Panax quinquefolium 100g, tortoise gum 200g etc. The traditional processing process of paste, Formulated by the preparation room of Shanxi Institute of traditional Chinese Medicine, standardized and standardized operation to ensure the quality and curative effect of plaster. Usage: 20 g / time after meal, 4 weeks a course of treatment in the morning and evening, The safety indexes of the two groups before and after treatment were recorded in detail. Syndrome indexes and 24-hour ambulatory blood pressure data (ABPM) were monitored by 9027.ABP ambulatory blood pressure recorder produced by SP(a)celabs Medical, USA, and the experimental data were collated and statistically analyzed. Results: 1. Evaluation of curative effect: 1. The total effective rate of the combined treatment group was 96. The total effective rate of the western medicine group was 83. The symptom improvement effect of the combined treatment group was significantly better than that of the control group.) the total effective rate of the combined treatment group was 96, which was higher than that of the western medicine group. After treatment, the ambulatory blood pressure variability of ABPVs, usually expressed by the coefficient of variation of blood pressure (CV), and the circadian rhythm were improved. The percentage of dipper blood pressure in the treatment group was 41%, which was significantly better than that in the control group 17. 2. Safety evaluation: there was no significant difference in the safety indexes between the two groups before and after treatment (P 0.05), and the drugs were all safe. Discussion on the effect of Pinggan Yixuan Ointment combined with L-amlodipine Benesulfonic Acid tablets in the treatment of liver Yang hyperactivity mild and moderate Hypertension, compared with the simple oral administration of L-amlodipine benzenesulfonic acid tablet group, The effect of lowering blood pressure is more significant and stable, the improvement of circadian rhythm of blood pressure and blood pressure variability is greater, and the risk of cardiovascular and cerebrovascular diseases can be reduced to a greater extent. 2. No safety problems such as liver and kidney function damage were found in the course of the trial. The medicine is safe and reliable.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R544.1

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