养血清脑丸联合马来酸依那普利叶酸片治疗H型高血压的临床研究

Effect of Yangxuenao Pill combined with enalapril maleate folic acid tablet on H-type hypertension

目的:探讨H型高血压患者以养血清脑丸与马来酸依那普利叶酸片联合治疗的临床疗效,及其对患者肾素-血管紧张素-醛固酮系统(RAAS)活性、免疫炎症指标和血清同型半胱氨酸(Hcy)水平的影响。方法:选取194例H型高血压患者作为研究对象,按治疗方式不同将患者分为对照组与观察组,每组各97例。对照组口服马来酸依那普利叶酸片治疗;观察组在此基础上联合养血清脑丸治疗,连续治疗12周后比较两组临床疗效。比较治疗前后两组24 h动态血压指标、血清RAAS指标水平、免疫炎症指标和血清Hcy水平。统计两组不良反应发生情况。自接受治疗开始对所有对象随访12个月,统计两组主要不良心脑血管事件(MACCE)发生情况。结果:观察组治疗总有效率(94.85%),高于对照组(82.47%)(P<0.05)。治疗后,两组白天平均舒张压(dDBP)、白天平均收缩压(dSBP)、夜间平均舒张压(nDBP)及夜间平均收缩压(nSBP)均降低,且观察组dDBP、dSBP及nSBP低于对照组(P<0.05)。治疗后,两组血清肾素活性、血管紧张素Ⅱ、醛固酮水平和全血中性粒细胞与淋巴细胞比值及血清补体C3、Hcy水平均降低(P<0.05),且观察组低于对照组(P<0.05)。两组不良反应总发生率无统计学差异(P>0.05)。对照组MACCE发生率为14.43%,高于观察组的5.15%(P<0.05)。结论:养血清脑丸联合马来酸依那普利叶酸片可增强对H型高血压患者血压和Hcy的双重调节作用,降压效果显著,且有利于降低心脑血管不良事件的发生风险,其作用可能与其进一步调节RAAS活性及体内免疫炎症状态有关。

Objective:To investigate the clinical efficacy of Yangxuenao pill combined with enalapril maleate folic acid tablets in patients with H-type hypertension,and its effects on renin-angiotensin-aldosterone system(RAAS)activity,immunoinflammatory indexes and serum homocysteine(Hcy)level.Methods:194 patients with H-type hypertension were selected and divided into observation group and control group according to different treatment methods,with 97 cases in each group.The control group was treated with enalapril maleate and folic acid tablets,on the basis of which the observation group was treated with Yangsera nao pill,and the clinical efficacy of the two groups was compared after continuous treatment for 12 weeks.The 24 h ambulatory blood pressure index,serum RAAS index,immunoinflammatory index and serum Hcy level were compared before and after treatment.The adverse reactions of the two groups were analyzed.Followed up for 12 months on all subjects since receiving treatment,and recorded the occurrence of major adverse cardiovascular and cerebrovascular events(MACCE)in both groups.Results:The total effective rate of observation group(94.85%)was higher than that of control group(82.47%,P<0.05).After treatment,the mean diastolic blood pressure(dDBP),mean diastolic blood pressure(dSBP),mean diastolic blood pressure(nDBP)and mean systolic blood pressure(nSBP)in the two groups were lower than before treatment,and the dDBP,dSBP and nSBP in the observation group were lower than those in the control group(P<0.05).After treatment,the serum renin activity,angiotensinⅡ,aldosterone levels,whole blood neutrophil to lymphocyte ratio and serum complement C3,and Hcy levels in both groups were decreased(P<0.05),and the observation group was lower than the control group(P<0.05).There was no significant difference in the adverse reaction rate between the two groups(P>0.05).The incidence of MACCE in the control group was higher than the observation group(14.43%vs.5.15%,P<0.05).Conclusion:Yangxuenao Pill combined with enalapril maleate folic acid tablet can enhance the dual regulation of blood pressure and Hcy in patients with H-type hypertension,with a significant antihypertensive effect and a beneficial reduction in the risk of cardiovascular and cerebrovascular adverse events.Its effect may be related to the further regulation of RAAS activity and immune inflammation in vivo.