中药脑心多泰胶囊联合治疗阴虚阳亢型高血压病患者对颈动脉重构的效果

Effect of naoxinduotai capsule on carotid artery remodeling in asthenic yin causing predominant yang symptom with primary hypertension in a randomized controlled trial

目的:观察中药脑心多泰胶囊治疗阴虚阳亢型高血压病患者对颈动脉重构的效果。方法:采用随机对照临床试验观察阴虚阳亢型高血压病患者40例,脑心多泰胶囊加培哚普利治疗20例为联合治疗组,单用培哚普利治疗20例为对照组,疗程2月。采用日本Aloka 5500超声诊断仪,检测治疗前后压力应变弹性系数(EP)、硬化值(β)、顺应性(AC)、脉搏波传导速度(PWV),增大指数(AI)及双侧颈动脉内中膜厚度(IMT)等。观察治疗前后中医证候积分及颈动脉血管重构变化。结果:联合治疗组中医证候积分呈明显下降趋势,疗效显著优于对照组(P<0.05)。联合治疗组EP,PWV,β均显著下降,AC显著提高,治疗前后差异有统计学意义(均P<0.05)。单用培哚普利组仅EP和PWV下降,治疗前后差异有统计学意义(P<0.05)。结论:脑心多泰胶囊联合培哚普利明显改善高血压病患者临床症状,降低血管硬度,提高顺应性,疗效优于单用培哚普利。

AIM： To observe the effects of naoxinduotai capsule （active principles of tribulus terrestris） on carotid artery remodefing in a randomized controlled clinical trial. METHODS： A randomized controlled trial was designed. Forty patients of asthenic yin causing predominant yang with primary hypertension （PH） were divided into two groups （n = 20 each） ; naoxinduotai capsule plus perindopril （trial group） and Perindopril group （control group）. The patients＇total of penthemeron integration syndrome, blood pressure, blood glucose, blood lipids and liver and kidney function were examined before and after treatment. Echo tracking ultrasonic parameters of carotid including pressure-strain elastic modulus （ Ep）, stiffness parameter （13）, arterial compliance （AC）, pulse wave velocity （PWV）, augmentation index （AI）, maximum vessel diameter, minimum vessel diameter, and intima media thickness （IMT） were obtained with echo tracking ultrasound technique. RESULTS： The sum of penthemeron integration syndrome had a statistically significant decreasing tendency after treatment, but the total in the trial group was statistically significantly lower than in the control group. EP, β and PWV decreased in a statistically significant manner and AC was statistically significantly increased in the trial group, whereas only statisti- cally significantly decreased EP and PWV decreased in a statistically significant manner in the control group （P 〈0. 05）. CONCLUSION： Naoxinduotai capsule combined with perindopril shows better results in not only improving clinical symptoms of asthenic yin causing predominant yang symptom with PH, but also shows better results in inhibiting arotid artery stiffness and compliance degradation compared with perindopril alone.