补肾降压水煎剂治疗早期高血压病临床相关性的研究

Study on the Treatment of Early Hypertension Disease with Invigorate Kidney and Depressurization Decoction(IKDD) and Correlative Factors of This Disease

目的:观察补肾降压水煎剂的降压效果及作用机制及高血压病肾精亏虚、痰瘀互结证发生的相关因素。方法:本课题采用补肾益精、化痰通络的补肾降压方治疗早期高血压病(Ⅰ、Ⅱ期)患者,同时设立西药怡那林(马来酸依那普利片)做为对照组,观察其治疗前后血压、临床症状、生化指标改善,评价中药治疗高血压病的效果,同时观察其在肾素、血管紧张素、氧自由基、血液流变学、血脂等方面的作用,揭示其作用机理。结果:中药组补肾降压水煎剂有明显降低血压的作用,其显效率为87%;有效率8%,总有效率为99%。西药组降压的显效率为80%;有效率20%,总有效率为100%,两组间降压效果相比无显著性差异;疗后中药组明显改善患者症状如头晕乏力、腰膝酸软、夜寐不安、耳鸣等;疗前舌质以淡红及淡红胖较多,疗后淡红舌占绝对优势,疗前舌苔以薄白及白腻苔为主,疗后薄白苔占绝对优势;疗前脉象以滑、细滑、弦滑为主,疗后脉象无明显变化,舌质、舌苔治疗后也有明显改善。结论:高血压病肾精亏虚、痰瘀互结证的主要相关因素为肥胖、吸烟、遗传、饮酒。主要诱发因素为劳累、情志、受寒、膳食等。补肾降压水煎剂有降低收缩压和舒张压的作用,随着治疗时间的延长降压效果越显著,且明显改善中医症状及舌质和舌苔。

Objective ： To study the effects of Invigorate kidney and Depressurization Decoction（IKDD） on decreasing blcod pressure and its mechanism of action, as well as to explore occurrence correlative factors of kidney - essence deficiency combined with interties of phlegm with blood stasis syndromes of hypertension disease. Methods ： The patients with early hypertension disease （ Ⅰ to Ⅱ stage） were treated with IKDD in the study. The western medicine Enalapril Maleate - Changzhou Pharm was taken orally by the patients in the control group. Follow indexes were detected and analyzed before and after treatment： blood pressure, clinical symptoms, biochemical criterion, rennin, angiotensin, oxygen free radical, blood fat and blood rheology indexes. Results ： Chinese drug IKDD had obvious effects on decreasing blood pressure, and the excellent rate was 87%, the good rate was 12%, the excellent and good rate was 99%. In control group, above rates were 80%, 20% and 100%. There was no statistical difference in therapeutic effects of Chinese drug and western medicine. But in patients treated with IKDD, such clinical symptoms as dizzy, debility, lassitude in loin and knee, unpeaceful sleep and ear noises obviously improved after treatment, as well as tongue proper and tongue fur improved. After treatment, most patients had light red tongue and thin and white tongue fur compared with light red and fat tongue, white and greasy tongue fur before treatment. The pulse condition had no obvious changes before and after treatment. Conclusion： The main occurrence correlative factors of kidney - essence deficiency combined with interties of phlegm with blood stasis syndromes of hypertension disease are as follows： fat, smoking, heredity and drinking. The main inducing factors are tiredness, emotion, cold and food. The Chinese drug IKDD has effects of decreasing both contractive pressure and diastolic pressure, and the effects enhanced gradually with prolong of treatment time. This decoction also improves clinical symptoms, tongue proper and tongue fur in patients with hypertension disease.