疏肝降火颗粒干预肝郁火旺型高血压病的临床研究

发布时间：2018-05-31 15:47

本文选题：高血压 + 疏肝降火颗粒　；参考：《河南中医药大学》2016年硕士论文

【摘要】：目的通过疏肝降火颗粒干预肝郁火旺型高血压病患者,观察治疗前后实验组与对照组中医证候积分、24动态血压及综合医院焦虑抑郁量表的积分的变化。评价疏肝降火颗粒在干预高血压病肝郁火旺型临床疗效。方法受试对象为2014.4~2015.10在河南中医药大学第三附属院心血管科门诊及病房诊断为高血压病肝郁火旺型60例患者,按照患者就诊序号采用随机数字表法,分为实验组30例和对照组30例,实验组给予疏肝降火颗粒(每日1付,分2次,早晚冲服)+苯磺酸氨氯地平片(络活喜,5mg/片,1片/日)治疗,对照组给予苯磺酸氨氯地平片,5mg/片,1片/日)治疗。药物均由河南中医药大学第三附属医院药剂科统一提供,观察8周后患者的中医证候积分、24h ABPM及医院综合焦虑抑郁量表积分的变化情况。收集数据采用SPSS19.0软件统计分析。结果实验组与对照组治疗前一般资料及观察指标相比较均满足(P0.05),无统计学差异,具有可比性。治疗前中医证候积分、24h SBP、24h DBP、dSBP、d-DBP、n-SBP、n-DBP、SCV、DCV及综合医院焦虑抑郁量表的积分等资料统计学上均无明显差异,具有可比性。两组治疗后中医症状积分及中医证候总疗效均较治疗前显著下降,有统计学意义(P0.05)。两组治疗后降压总疗效较治疗前有改善,实验组有效率为90.00%,对照组总有效率为73.30%。经统计分析两组间(P0.05),表明实验组在改善高血压病患者的中医证候显著优于对照组;在改善(24h SBP、24h DBP、d-SBP、d-DBP、nSBP、n-DBP)方面实验组显著优于对照组,经统计分析两组间(P0.05);实验组能显著改善血压变异性,经统计分析(P0.05),对照组对血压变异性改善不明显,经统计分析(P0.05);治疗后焦虑抑郁分布及积分较治疗前均有显著改善,经统计分析(P0.05),实验组在改善焦虑抑郁方面显著优于对照组。结论根据观察结果显示疏肝降火颗粒联合苯磺酸氨氯地平片明显改善肝郁火旺型高血压病患者的中医证候、24h ABPM及焦虑抑郁情绪的作用,同时发现肝郁火旺型高血压病患者在一定程度上伴有焦虑抑郁的状态,且焦虑状态居多,及时控制血压能有效的减少焦虑抑郁的发生,其从疏肝降火、息风止眩入手,降低患者24h ABPM及改善患者焦虑抑郁情绪的作用,但中药联合西药在治疗高血压病患者血压和改善焦虑抑郁的情绪优于单纯西药。验证了疏肝降火颗粒治疗高血压病伴焦虑抑郁的临床疗效,为高血压病的治疗提供新的思路。
[Abstract]:Objective to observe the changes of ambulatory blood pressure (ABBP) in experimental group and control group before and after treatment with Shugan Jianghuo granule (Shugan Jianghuo granule) and the scores of anxiety and depression scale in general hospital before and after treatment. Objective: to evaluate the clinical effect of Shugan Jianghuo granule (Shugan Jianghuo granule) in treating essential hypertension with stagnation of liver and fire. Methods Sixty patients with essential hypertension, liver stagnation and fire flourishing type were diagnosed in the Department of Cardiovascular Department and ward of the third affiliated Hospital of Henan University of traditional Chinese Medicine on October 10, 2014. According to the number of the patients, the random digital table method was used. Three groups were divided into experimental group (30 cases) and control group (30 cases). The experimental group was treated with Shugan Jianghuo granule (1 daily, divided into 2 times, taken sooner or later) amlodipine benzenesulfonic acid tablets (5 mg / tablet / day). The control group was treated with amlodipine benzenesulfonate (5 mg / d). All drugs were provided by the Pharmacy Department of the third affiliated Hospital of Henan University of traditional Chinese Medicine. The changes of TCM syndromes score 24 h ABPM and hospital comprehensive anxiety and depression scale were observed after 8 weeks. The data were collected and analyzed by SPSS19.0 software. Results the comparison of general data and observation index before treatment between the experimental group and the control group had no statistical difference and was comparable. Before treatment, there was no statistical difference in the score of TCM syndromes (24 h SBP) and 24 h DBP (dSBPn) -DBP (n-SBP) -DBP (n-DBP), SCVV (DCV), and the scores of anxiety and depression scale (SAS) in general hospital, which were comparable to each other. After treatment, the scores of TCM symptoms and the total curative effect of TCM syndromes in both groups were significantly lower than those before treatment, with statistical significance (P 0.05). The total effect of hypotension in the two groups was improved after treatment. The effective rate was 90.00in the experimental group and 73.30g in the control group. The statistical analysis showed that the experimental group was significantly better than the control group in improving the TCM syndromes of hypertensive patients, and in improving the 24h DBPnPnSBPnSBPnSBPnDBPn in the experimental group, the experimental group was significantly better than the control group in improving the symptoms of hypertension, and in improving the 24h SBP of the control group, the experimental group was significantly better than the control group. After statistical analysis, the blood pressure variability was significantly improved in the experimental group, but not in the control group, and the distribution of anxiety and depression and the score in the control group were significantly improved compared with those before treatment. By statistical analysis, the experimental group was significantly better than the control group in improving anxiety and depression. Conclusion according to the observation results, Shugan Jianghuo granule combined with amlodipine benzenesulfonic acid tablets can obviously improve the effect of TCM syndromes 24 h ABPM and anxiety and depression in patients with liver depression. At the same time, it was found that the patients with hypertension of liver depression and fire were accompanied with anxiety and depression to a certain extent, and the anxiety state was the most. Timely control of blood pressure could effectively reduce the occurrence of anxiety and depression, which began from soothing the liver and lowering the fire and stopping the dizziness and dizziness of the wind. The effects of Chinese medicine combined with western medicine on blood pressure and anxiety and depression in patients with hypertension were better than those of western medicine alone. The clinical efficacy of Shugan Jianghuo granule in the treatment of hypertension with anxiety and depression was verified and a new idea was provided for the treatment of hypertension.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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