联服川芎素、培哚普利与单服培哚普利对高血压患者血管内皮功能和血压的影响

Combined Ferulic acid and Perinopril Treatment in Essential Hypertension

目的观察和比较联服川芎素(阿魏酸钠,中药川芎的主要有效活性物质之一)、培哚普利与单服培哚普利治疗高血压(EH)患者前、后血浆内皮素1(ET-1)、一氧化氮(NO)水平和血压(BP)的变化,以了解其对血管内皮功能和BP的影响,并试图探索一种传统中药制剂与新型西药相结合治疗EH的新方法。方法60例EH随机单盲分为A、B组,A组30例联服川芎素、培哚普利,B组30例单服培哚普利,疗程4周,分别在治疗前、后测量BP和血浆ET-1、NO水平。另设正常对照组30例。结果A、B组治疗4周后与治疗前比较,血浆ET-1、NO及BP均有显著改善(P<0·01或P<0·05),治疗后两组间比较,ET-1A组(81·7±20·4)pg/mL比B组(108·6±28·5)pg/mL(P<0·01),NOA组(40·4±7·3)比B组(29·6±7·2)μmol/L(P<0·01)及收缩压(SBP)A组(138·9±8·1)mmHg比B组(143·1±8·5)mmHg,舒张压(DBP)A组(81·9±4·8)mmHg比B组(86·2±4·3)mmHg(P<0·01)。未见有明显药物不良反应。结论川芎素口服可用于EH患者的辅助治疗,联服川芎素、培哚普利4周后在改善血管内皮功能方面具有协同作用,亦有更优的BP控制,不失为传统中药制剂与新型西药相结合治疗EH的又一有效方法。

Objective Study the effect of Chuanxiongsu（ferulic acid） combined perindopril or perindopril alone in the treatment of essential hypertension （ EH）. Methods Sixty patients with EH were divided into two groups randomly and single blindly： group A received Chuanxiongsu combined with perindopril, while group B received perindopril alone（ 4-8 mg/d） only for four weeks. Plasma endothelin-1 concentration（ ET-1 ） and nitric oxide （ NO） concentration were determined with radiommunoassay（ RIA）. Blood pressure was monitored before and after treatment. Thirty healthy volunteers served as controls. Results SBP in group A was lower than that in group B（ 138.9±8. 1 vs group B 143.1 ±8. 5）mm Hg, P〈0.05; DBP：81.9±4. 8 vs group B 86.2±4.3 mm Hg,P〈0.05. Compared with group B, plasma level of NO after treatment in group A was 40.4±7.3 vs group B 29.6±7.2 μmol/L（ P〈0.01）, while ET-1 was 81.7±20. 4 vs group B 108.6± 28. 5 pg/mL, P〈0.01. Conclusion On the basis of perindopril treatment adding Chuanxiongsu was shown to have synergic antihypertensive effects on treating EH. The effect of combined treatment need further study.