心可舒胶囊联合马来酸依那普利叶酸片治疗H型高血压合并左心室肥厚的临床研究

Clinical study of Xinkeshu capsules combined with enalapril maleate folic acid tablets in the treatment of H-type hypertension with left ventricular hypertrophy

目的探讨心可舒胶囊联合马来酸依那普利叶酸片治疗H型高血压合并左心室肥厚(LVH)患者的效果及安全性。方法选取2021年1月至2022年10月在武汉科技大学附属老年病医院接受治疗的H型高血压合并LVH患者168例,根据随机数字表法分为对照组(84例)和观察组(84例)。对照组患者采用马来酸依那普利叶酸片进行治疗;观察组患者采用马来酸依那普利叶酸片联合心可舒胶囊进行治疗。2组均治疗6个月。比较2组临床疗效,治疗前和治疗6个月后收缩压、舒张压、同型半胱氨酸(Hcy)及心功能指标水平。统计2组不良反应发生情况。结果观察组治疗总有效率高于对照组[94.0%(79/84)比83.3%(70/84)],差异有统计学意义(P=0.028)。治疗6个月后2组患者的收缩压、舒张压、Hcy明显低于治疗前,且观察组收缩压、舒张压、Hcy均低于对照组(均P<0.05)。治疗6个月后2组患者的左心室后壁厚度、室间隔厚度略有降低,但组间及组内比较差异均无统计学意义(均P>0.05)。治疗6个月后2组患者的左心室质量指数(LVMI)、左心室舒张末期内径(LVEDD)明显低于治疗前,且观察组LVMI、LVEDD均低于对照组(均P<0.05)。对照组与观察组总不良反应发生率比较[7.1%(6/84)比8.3%(7/84)],差异无统计学意义(P=0.773)。结论心可舒胶囊联合马来酸依那普利叶酸片治疗H型高血压合并LVH患者具有较好的降压效果,同时也能明显改善患者的左心室功能、降低血清Hcy水平,且安全性较好。

Objective To investigate the efficacy and safety of Xinkeshu capsules combined with enalapril maleate folic acid tablets in the treatment of patients with H-type hypertension with left ventricular hypertrophy(LVH).Methods Totally 168 patients with H-type hypertension with LVH admitted to Wuhan University of Science and Technology Affiliated Geriatric Hospital from January 2021 to October 2022 were selected.According to the random number table method,patients were divided into control group(84 cases)and observation group(84 cases).The control group patients were treated with enalapril maleate folic acid tablets,while the observation group patients were treated with Xinkeshu capsules on the basis of the control group.Both groups were treated for 6 months.The treatment efficacy,the systolic blood pressure(SBP),diastolic blood pressure(DBP),homocysteine,and cardiac function indicators before and after 6 months of treatment of two groups were compared.The occurrence of adverse reactions in two groups were counted.Results The total effective rate of the observation group was higher than that of the control group[94.0%(79/84)vs 83.3%(70/84)](P=0.028).After 6 months of treatment,levels of SBP,DBP,and homocysteine in the two groups were significantly reduced,and the levels in the observation group were lower than those in the control group(all P<0.05).After 6 months of treatment,the left ventricular posterior wall thickness and interventricular septal thickness in the two groups slightly decreased,but there was no statistically significant difference between the groups and within the group(all P>0.05).After 6 months of treatment,the left ventricular mass index(LVMI)and left ventricular end diastolic diameter(LVEDD)in the two groups significantly decreased,and LVMI and LVEDD in the observation group were greater than those in the control group(all P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the control group and observation group[7.1%(6/84)vs 8.3%(7/84)](P=0.773).Conclusions The combination of Xinkeshu capsules and enalapril maleate folic acid tablets has a good antihypertensive effect on patients with H-type hypertension complicated with LVH.It can also significantly improve left ventricular function,reduce serum homocysteine level,and has high safety.