补肾法治疗肾虚型高血压患者中医证候及生活质量的临床观察

发布时间：2018-07-10 11:39

本文选题：补肾降压方 + 补肾益心片　；参考：《广州中医药大学》2016年硕士论文

【摘要】：目的：高血压的治疗目标是包括降压在内的靶器官保护、总体心血管风险降低以及生活质量的提高。本研究旨在通过探讨补肾法(补肾降压方与补肾益心片)治疗轻中度高血压患者降压疗效、中医证候及病人生活质量改善情况,总结临床经验,为中医临床辨治高血压进一步提供有益的依据。方法：本研究拟采用前瞻性随机对照的临床研究方法,根据《中药新药临床研究指导原则》,纳入临床上诊断为肾虚型高血压患者100例。将患者随机分成两组,其中治疗组50例和对照组50例。治疗组予基础西药苯磺酸氨氯地平片1片QD降压加用补肾降压方与补肾益心片治疗；对照组予基础西药苯磺酸氨氯地平片1片QD降压,疗程观察为3个月。然后观察并统计评估治疗前后患者血压、中医证侯评分、病人生理状况、工作状态、睡眠、生活质量等临床疗效。结果：临床研究表明,两组均具有良好的降压效果,降压总有效率(治疗组VS对照组：95% VS 90%)；24h动态血压疗效观察：治疗前后两组谷峰比及平滑指数组内比较均具有统计学显著性差异,两组治疗前后谷峰比与平滑指数组间差值比较均具有统计学显著差异(p0.01),治疗组优于对照组；生活质量改善方面,治疗前后两组多项指标均有改善,但治疗组明显优于对照组指标。进一步表明对于肾虚型高血压患者,在常规运用苯磺酸氨氯地平片进行降压的同时,使用中医药补肾降压方与补肾益心片治疗进一步提高了单纯使用西药的疗效。结论：在常规苯磺酸氨氯地平片降压治疗的基础上,并给予补肾降压方与补肾益心片中医辨证治疗,可进一步平稳控制血压,改善患者生活质量,如躯体化状况、生理症状、工作状态、睡眠改善等。同时,也为中医运用汤剂与片剂联合辨证论治高血压病提供了实用的方法和依据。
[Abstract]:Objective: the aim of treatment for hypertension is to protect target organs including hypotension, reduce overall cardiovascular risk and improve quality of life. The purpose of this study was to summarize the clinical experience of Bushen Jiangya decoction and Bushen Yixin tablet in the treatment of patients with mild and moderate hypertension by exploring the antihypertensive effect, TCM syndromes and the improvement of patients' quality of life. To provide a useful basis for the clinical treatment of hypertension. Methods: a prospective randomized controlled clinical study was carried out in 100 cases of hypertension with kidney deficiency according to the guiding principles of New Chinese Medicine Clinical Research. Patients were randomly divided into two groups: treatment group (n = 50) and control group (n = 50). The treatment group was treated with basic western medicine amlodipine benzenesulfonic acid (QD) 1 tablet QD combined with Bushen Jiangya decoction and Bushen Yixin tablet while the control group was treated with basic western medicine amlodipine benzenesulfonic acid 1 tablet QD and the course of treatment was observed for 3 months. Then observe and evaluate the clinical effect of blood pressure, TCM syndrome score, patient's physiological status, working state, sleep, quality of life before and after treatment. Results: the clinical study showed that both groups had good antihypertensive effect and the total effective rate was 90% (vs control group: 95% vs 90%). Observation of 24-hour ambulatory blood pressure: there were significant differences between the two groups before and after treatment. The difference between the two groups before and after treatment was statistically significant (p0.01), the treatment group was better than the control group, the improvement of quality of life, the two groups before and after treatment of a number of indicators improved, But the treatment group was better than the control group. It is further indicated that the traditional use of amlodipine benzenesulfonic acid tablets for lowering blood pressure, the use of traditional Chinese medicine Bushen Jiangya prescription and Bushen Yixin tablet to further improve the efficacy of the use of western medicine. Conclusion: on the basis of antihypertensive therapy of amlodipine benzenesulfonic acid tablets and traditional Chinese medicine differentiation treatment of Bushen Jiangya decoction and Bushen Yixin tablet, the blood pressure can be controlled steadily and the quality of life of patients can be improved, such as somatization and physiological symptoms. Work status, sleep improvement, etc. At the same time, it also provides the practical method and basis for the treatment of hypertension with decoction and tablet combined with syndrome differentiation.
【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】：2016
【分类号】：R259

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