化痰安神熄风方治疗原发性高血压痰浊上扰证的疗效及对相关靶器官损害的影响

Effect of Huatan Anshen Xifeng Formula(化痰安神熄风方)on Hypertension Patients with Phlegm Turbidity and Related Target Organ Damage

目的:探讨化痰安神熄风方治疗原发性高血压痰浊上扰证的临床疗效,并观察化痰安神熄风方对高血压靶器官损害及相关预测指标的影响。方法:纳入100例原发性高血压伴轻度靶器官损害患者,按照随机数字表法将患者分为治疗组及对照组各50例。对照组患者予口服降压药及一般常规治疗;治疗组患者在对照组基础上予化痰安神熄风方口服,两组均治疗12周。评价两组患者治疗后的临床疗效,比较两组患者治疗前后中医证候积分、24 h平均收缩压(24 h SBP)、24 h平均舒张压(24h DBP)、24 h平均收缩压变异系数(24 h SBPV)、24 h平均舒张压变异系数(24 h DBPV)、左心室质量指数(LVMI)、尿微量白蛋白/肌酐比(UACR)、颈动脉内膜中层厚度(IMT)、单核细胞与高密度脂蛋白胆固醇比值(MHR)、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)的变化,并将靶器官相关损害指标与MHR、NLR、PLR进行相关分析。结果:治疗组总有效率为90.00%(45/50),对照组总有效率为70.00%(35/50),治疗组高于对照组(P<0.05);两组患者治疗后中医证候总积分均较治疗前下降,且治疗组患者治疗后中医证候总积分低于对照组,差异均有统计学意义(P<0.05);两组患者治疗后24 h SBP、24 h DBP、24 h SBPV、24 h DBPV、LVMI、UACR、IMT、MHR、NLR、PLR均较治疗前下降,且治疗组患者治疗后24 h SBP、24 h DBP、24 h SBPV、24 h DBPV、LVMI、UACR、IMT、MHR、NLR、PLR均低于对照组,差异有统计学意义(P<0.05)。Spearman相关性分析显示,MHR与LVMI(r=0.244)、UACR(r=0.281)、IMT(r=0.253)之间均呈正相关(P<0.05),且三者与MHR均呈低度相关;NLR与LVMI(r=0.414)、UACR(r=0.526)、IMT(r=0.458)之间均呈正相关(P<0.05),且三者与NLR均呈中度相关;PLR与LVMI(r=0.462)、UACR(r=0.620)、IMT(r=0.605)之间均呈正相关(P<0.05),且三者与PLR均呈中度相关。结论:化痰安神熄风方能有效调节原发性高血压痰浊上扰证患者的24 h动态血压及血压变异性,改善患者LVMI、UACR、IMT,调节MHR、NLR、PLR变化,且MHR、NLR、PLR与LVMI、UACR、IMT的变化相关。

Objective:To explore the clinical efficacy of Huatan Anshen Xifeng Formula(HTASXFF)on primary hypertension patients with phlegm turbidity disturbance,and to observe the effect of this compound on target organ damage and related predictive indicators of hypertension.Methods:100 patients with primary hypertension and mild target organ damage were selected and randomly divided into observation group and control group with 50 cases in each.The control group was treated with oral antihypertensive drugs and general routine treatment,on the basis of the treatment in the control group,the observation group was given oral Chinese herbal compound HTASXFF,and both groups were treated for 12 weeks.Compare the clinical efficacy of the two groups of patients after treatment,and compare the TCM syndrome score,24-hour mean systolic blood pressure(24 h SBP),24-hour mean diastolic blood pressure(24 h DBP),24-hour mean systolic blood pressure variation coefficient(24 h SBPV),24-hour mean diastolic blood pressure variation coefficient(24 h DBPV),left ventricular mass index(LVMI),urinary microalbumin/creatinine ratio(UACR),carotid intima media thickness(IMT)Changes in monocyte to high-density lipoprotein ratio(MHR),neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),and correlation of target organ related damage indicators with MHR、NLRand PLR were compared.Results:The total effective rate of the treatment group was 90.00%(45/50),while the total effective rate of the control group was 70.00%(35/50).The treatment group was higher than the control group(P<0.05).After treatment,the total scores of TCM syndromes in both groups decreased compared to before treatment,and the total scores of TCM syndromes in the treatment group was lower than that in the control group,with statistical significance(P<0.05).The 24 h SBP,24 h DBP,24 h SBPV,24 h DBPV,LVMI,UACR,IMT,MHR,NLR,PLR in both groups decreased compared with those in the pre-treatment group,and the 24 h SBP,24 h DBP,24 h SBPV,24 h DBPV,LVMI,UACR,IMT,MHR,NLR,PLR in the treatment group were lower than those in the control group,all showing significant differences(P<0.05).Spearman correlation analysis showed that there was a positive correlation between MHR and LVMI(r=0.244),UACR(r=0.281),IMT(r=0.253),and all three showed a low degree of correlation with MHR.There is a positive correlation between NLR and LVMI(r=0.414),UACR(r=0.526),IMT(r=0.458),and all three are moderately correlated with NLR.PLR was positively correlated with LVMI(r=0.462),UACR(r=0.620),and IMT(r=0.605),and all three were moderately correlated with PLR.Conclusion:Huatan Anshen Xifeng Formula can effectively regulate the 24-hour ambulatory blood pressure and blood pressure variability in patients with primary hypertension due to the disturbance of phlegm turbidity,and can improve LVMI、UACR、IMT and regulate the changes of MHR,NLR,PLR.MHR,NLR,PLR are closely related to the changes of LVMI、UACR、IMT.