活血化瘀利水中药复方治疗H型高血压伴颈动脉硬化临床疗效观察

发布时间：2018-09-09 19:12

【摘要】：目的:探讨活血化瘀利水中药复方对H型高血压伴颈动脉硬化患者治疗前后患者血浆同型半胱氨酸水平、血压、颈动脉内膜-中膜厚度及患者血瘀症候评分的变化。方法:本研究将80例入选患者按随机对照法,分为两组,每组各40例,治疗组与对照组均口服HMG-CoA还原酶选择性抑制剂阿托伐他汀钙片及叶酸片;治疗组及对照组高血压病1级患者均首选ACEI类一线降压药依马来酸那普利片;高血压病2级患者在血压控制不理想时即改为二联用药,在马来酸依那普利片基础上联合第二种降压药,首选CCB类一线降压药苯磺酸氨氯地平片。治疗组在西药治疗基础上加用活血利水中药复方,疗程为90天。观察两组治疗前后血浆同型半胱氨酸水平、血压及颈动脉内膜-中膜厚度变化。结果:1.联合使用活血化瘀利水中药复方的治疗组在降低血浆Hcy水平上优于对照组。2.在改善动态血压相关参数指标上,在西药降压药的基础上加用活血化瘀利水中药复方的治疗组表现出优于单纯使用西药降压药的效果。3.加用活血化瘀利水中药复方的治疗组在颈动脉内膜中层厚度改善程度上较运用阿托伐他汀钙片的对照组更为明显。4.活血化瘀利水中药复方的治疗组血瘀证评分低于单纯西药治疗的治疗组,提示活血化瘀利水中药复方对治疗血瘀证为主要病因病机的H型高血压伴颈动脉硬化切实有效。5.治疗组和对照组在治疗期间并未发现明显的副作用。结论:联合使用活血化瘀利水中药复方干预治疗H型高血压伴颈动脉硬化患者在降低患者血浆同型半胱氨酸水平、血压及颈动脉内膜-中膜厚度,以及患者血瘀证评分方面优于单纯西药治疗的对照组,观察期内未发现不良反应。
[Abstract]:Objective: to investigate the changes of plasma homocysteine level, blood pressure, carotid intima-media thickness and blood stasis syndrome score in patients with H type hypertension and carotid arteriosclerosis before and after treatment. Methods: 80 patients were randomly divided into two groups, 40 cases in each group. Both the treatment group and the control group were treated with HMG-CoA reductase selective inhibitor Atto vastatin calcium tablets and folic acid tablets. In both the treatment group and the control group, the first-line hypotensive drug of ACEI was first used in the treatment group and the control group, and the second grade hypertension patient was treated with two drugs when the blood pressure control was not satisfactory. In addition to enalapril maleate tablets combined with the second antihypertensive drug, the first choice of CCB first-line antihypertensive tablet amlodipine benzenesulfonic acid. The treatment group was treated with traditional Chinese medicine prescription of promoting blood circulation and promoting water on the basis of western medicine. The course of treatment was 90 days. Plasma homocysteine level, blood pressure and carotid intima-media thickness were observed before and after treatment. The result is 1: 1. The treatment group was superior to the control group in lowering plasma Hcy level. On the basis of improving the parameters of ambulatory blood pressure, the treatment group treated with traditional Chinese medicine for promoting blood circulation and removing stasis and promoting water on the basis of western medicine for lowering blood pressure showed better effect than western medicine for lowering blood pressure. The improvement of carotid intima-media thickness in the treatment group was more obvious than that in the control group treated with Atto vastatin calcium tablets. The score of blood stasis syndrome in the treatment group was lower than that in the treatment group treated by western medicine alone. It suggested that the traditional Chinese medicine prescription for activating blood circulation and removing stasis and promoting water was effective in treating H type hypertension with carotid arteriosclerosis as the main etiology and pathogenesis of blood stasis syndrome. No significant side effects were found in the treatment group and the control group during treatment. Conclusion: the treatment of H type hypertension with carotid arteriosclerosis with combined use of traditional Chinese medicine for promoting blood circulation and removing blood stasis and promoting water supply can reduce plasma homocysteine level, blood pressure and intima-media thickness of carotid artery, and decrease plasma homocysteine level, blood pressure and carotid intima-media thickness in patients with H type hypertension. The score of blood stasis syndrome was better than that of the control group treated with western medicine alone, and no adverse reactions were found in the observation period.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

【相似文献】