加味二至丸对绝经后女性高血压患者雌激素、血脂、内皮功能影响的临床研究

发布时间：2018-12-29 09:01

【摘要】：目的:观察加味二至丸对绝经后女性高血压患者雌激素、血脂、内皮功能的影响。方法:本研究为前瞻性研究,采用随机对照的方法,筛选广州中医药大学第一附属医院心血管内科2014年7月-2015年3月住院部及门诊自然绝经的高血压病患者60例。将上述60例患者按随机数字表法分为对照组和治疗组,其中对照组30例,治疗组30例。对照组:高血压病1级患者不予西药治疗,高血压病2级患者予苯磺酸氨氯地平片和厄贝沙坦片联合治疗。治疗组:在与对照组相同西医治疗方案基础上加用加味二至丸颗粒。两组患者分别于治疗0周和治疗4周时取禁食10小时后外周静脉血3ml离心后备用,电化学发光法测定雌二醇(Estradiol,E2)、双抗体夹心法测定血清一氧化氮(Nitric oXide,N0)及内皮素-1(Endothelin-1,ET-1)水平,速率法测定肝功能,酶法测定肾功能,胆固醇氧化酶(C0D-PAP)法测总胆固醇(Total cholesterol,TC),甘油磷酸氧化酶—过氧化物酶(GP0-PAP)法测定甘油三酯(Triglyceride,TG),采用阻抗、激光散射和荧光染色技术检测法测定白细胞(White blood cells,WBC)、红细胞(Red blood cell,RBC)、血红蛋白(Hemoglobin,HGB)、血小板(Platelet,PLT)。两组患者分别于治疗0周和治疗4周时填写改良Kupperman表格。所有实验数据采用SPSS19.0软件处理,计量资料采用均数士标准差表示,计量资料组内比较采用配对t检验,计量资料组间比较采用方差分析,计数资料构成比、率的组间及治疗前后比较用χ2检验,等级资料用秩和检验,p0.05表示差异有统计学意义,p0.01表示有显著统计学意义。结果:1.干预0周时,两组患者治疗前的年龄、绝经时间、高血压病程、E2、TG、TC、N0、ET-1、Scr、ALT、AST及血液分析水平比较差异无统计学意义(p0.05),两组患者间具有可比性,治疗过程中,治疗组无病例脱落。2.性激素缺乏症状:干预4周后,与对照组比较,治疗组患者治疗改良Kupperman总分的下降及疗效指数的升高有显著统计学差异(P0.05)。3.雌二醇:干预4周后,与对照组比较,治疗组的雌激素水平无显著统计学差异(p0.05)。4.血脂:干预4周后,与对照组比较,治疗组的TC、TG水平下降程度有统计学意义(p0.05)。5.内皮功能指标:干预4周后,与对照组比较,治疗组的N0水平上升程度及ET-1水平下降程度有统计学意义(P0.05)。6.安全性评估:干预4周后,与对照组比较,治疗组的肝肾功能指标无显著统计学差异(P0.05)。.结论:加味二至丸有改善患者雌激素缺乏症状,降低TC、TG、ET-1水平及升高N0水平的作用,对绝经后女性高血压患者的E2水平无明显影响,推测加味二至丸可能通过拟雌激素样作用改善绝经后女性高血压患者的雌激素缺乏症状、血管内皮功能及降低TC、TG,对绝经后女性高血压患者的肝肾功能无急性损害。
[Abstract]:Aim: to observe the effects of Jiawei Erzhi pill on estrogen, blood lipid and endothelial function in postmenopausal women with hypertension. Methods: this study was a prospective study. A randomized controlled study was used to screen 60 patients with hypertension in the Department of Cardiovascular Medicine of the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine from July 2014 to March 2015. The above 60 patients were randomly divided into control group and treatment group, including 30 cases in control group and 30 cases in treatment group. Control group: patients with hypertension grade 1 were not treated with western medicine, patients with hypertension grade 2 were treated with amlodipine benzenesulfonic acid and irbesartan tablets. Treatment group: in the control group on the basis of the same Western medicine treatment program plus Jiawei Erzhi Pill granule. After fasting for 10 hours, peripheral venous blood 3ml was centrifuged and estradiol (Estradiol,E2) was measured by electrochemiluminescence and serum nitric oxide (Nitric oXide, was determined by double antibody sandwich method. The levels of N0) and endothelin-1 (Endothelin-1,ET-1), liver function, renal function, cholesterol oxidase (C0D-PAP) and total cholesterol (Total cholesterol,TC) were measured by rate method, renal function and cholesterol oxidase (C0D-PAP) method, respectively. Glycerophosphate oxidase peroxidase (GP0-PAP) method was used to determine triglyceride (Triglyceride,TG), leucocyte (White blood cells,WBC and erythrocyte (Red blood cell,RBC were detected by impedance, laser scattering and fluorescence staining. Hemoglobin (Hemoglobin,HGB), platelet (Platelet,PLT). The modified Kupperman form was completed at 0 weeks and 4 weeks after treatment in both groups. All the experimental data were processed by SPSS19.0 software, the measurement data were represented by the standard deviation of the mean value, the comparison in the measurement data group was matched t test, the analysis of variance was used in the comparison between the measurement data groups, and the composition ratio of the counting data was calculated. 蠂 2 test and rank sum test were used in the comparison of the rates between groups and before and after treatment. The difference was statistically significant between p0.05 and p0.01, respectively. Results: 1. At 0 weeks after intervention, there was no significant difference in age, menopausal time, course of hypertension, E2TGG TC0 / ET-1 and blood analysis between the two groups (p0.05). Two groups of patients are comparable, treatment process, treatment group, no cases fall off. 2. Sex hormone deficiency symptoms: after 4 weeks of intervention, compared with the control group, the total score of modified Kupperman and the increase of curative effect index in the treatment group were significantly lower than those in the control group (P0.05). Estradiol: after 4 weeks of intervention, there was no significant difference in estrogen level between the treatment group and the control group (p0.05). Blood lipids: after 4 weeks of intervention, compared with the control group, the level of TC,TG in the treatment group decreased significantly (p0.05). Endothelial function index: after 4 weeks of intervention, compared with the control group, the level of N0 increased and the level of ET-1 decreased significantly in the treatment group (P0.05). Safety assessment: after 4 weeks of intervention, there was no significant difference in liver and kidney function between the treatment group and the control group (P0.05). Conclusion: Jiawei Erzhi pills can improve the symptoms of estrogen deficiency, decrease the level of TC,TG,ET-1 and increase the level of N0, but have no effect on the level of E2 in postmenopausal women with hypertension. It is speculated that Jiawei Erzhi pills can improve the symptoms of estrogen deficiency in postmenopausal women with hypertension, and decrease the function of vascular endothelium and decrease of TC,TG, on the liver and kidney function of postmenopausal women with hypertension.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R544.1

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