燮理阴阳复方干预高血压左心室肥厚临床研究

Clinical study of "Compound Xieliyinyang Decoction" on the treatment of hypertensive left ventricle hypertrophy

目的探讨燮理阴阳复方对高血压左心室肥厚(LVH)的干预作用。方法将75例高血压LVH患者随机分为治疗组与对照组。对照组34例单纯服用氯沙坦钾,治疗组41例予氯沙坦钾联合燮理阴阳复方。两组疗程均为2个月,观察临床症状、血压、左心室重构的相关指标及左心功能的变化情况。结果治疗后两组患者血压及中医证候积分均有明显改善(P<0.01),且治疗组的收缩压与中医证候积分均明显低于对照组(P<0.05,P<0.01)。两组治疗后超声心动图各项指标均较治疗前明显改善(P<0.05,P<0.01),且治疗组左室后壁厚度(LVPWT)、左心室重量(LVM)、左心室重量指数(LVMI)较对照组降低明显(P<0.05)。两组治疗后左心功能指标除左室射血分数(LVEF)无明显改变外,左室短轴缩短率(FS)、心输出量(SV)、每搏输出量(CO)、心脏指数(CI)均较治疗前明显改善(P<0.05,P<0.01),其中治疗组对SV、CO、CI的改善优于对照组(P<0.05,P<0.01)。结论燮理阴阳复方联用降压西药在改善高血压左心室肥厚患者临床症状、降低血压的同时,还可逆转高血压左心室肥厚,改善左心功能。

Objective To observe the intervention effect of ＂Compound Xieliyinyang Decoction＂ on hypertensive left ventricle hypertrophy. Methods Seventy- five cases were randomized into two groups： control group in which 34 cases were treated by Losartan Potassium, and treatment group in which 41 cases were treated by combination of Losartan Potassium and ＂Compound Xieliyinyang Decoction＂, with the course of 24 weeks. The clinical symptoms, blood pressure, correlative indexes of ventricular remodeling and left heart function were observed. Results After treatment, the blood pressure and TCM symptom score in the two groups were obviously improved （ P 〈 0.01 ） , and the systolic blood pressure and symptom score in treatment group were significantly lower than control group （ P 〈 0.05 or P 〈 0.01 ） ; the indicators of ultrasonic cardiogram were improved markedly after treatment （P 〈 0.05 or P 〈 0.01 ）. The left ventricular posterior wall thickness （LVPWT） , left ventricular mass （LVM） , left ventricular mass index （LVMI） of treatment group were reduced significantly （P 〈0.05 ）. Except for left cardiac EF, the other indexes such as the rate of left ventricular short axis shortening （FS） , stroke volume （ SV）, cardiac output （CO） , cardiac index （CI） in both groups were significantly improved （P 〈0.05 or P 〈0.01 ）, and the improvement of SV, CO and C1 in treatment group were superior to that of the control group （P 〈 O. 05 or P 〈 0.01 ）. Conclusion Combined ＂Compound Xieliyinyang Decoction＂ and antihypertensive medicine can improve the clinical symptoms, lower the blood pressure, reverse the LVH and improve the left cardiac function.