氨氯地平联合替米沙坦联合与氨氯地平联合阿米洛利联合治疗原发性高血压的疗效比较

The clinical efficacy of combination of amlodipine and amiloride compared with amlodipine and telmisartan on primary hypertesion

目的以氨氯地平和阿米洛利作对照,观察氨氯地平和替米沙坦的降压疗效。方法 50例高血压患者,停用降血压药2周随机分为治疗组(A组)25例,口服氨氯地平2.5mg/d和替米沙坦40mg/d;对照组(B组)25例,口服氨氯地平2.5mg/d和复方阿米洛利半片/d(含阿米洛利1.25mg,氢氯噻嗪12.5mg)。治疗8周,观察血压、心率、电解质、肝肾功能及不良反应等。结果氨氯地平+替米沙坦组及氨氯地平+阿米洛利组治疗前收缩压分别为:(176.4±12.8)mmHg和(173.7±14.2)mmHg,舒张压分别为:(105.7±8.2)mmHg和(103.5±9.3)mmHg,在治疗8周后收缩压分别为:(123.2±15.3)mmHg和(132.5±12.8)mmHg,舒张压分别为:(81.8±6.7)mmHg、(84.0±7.9)mmHg,两组治疗前后收缩压与舒张压下降均差异有统计学意义(P<0.05),组间比较差异有统计学意义(P均<0.05)。8周治疗后替米沙坦和氨氯地平组降压总有效率为92%,而阿米洛利和氨氯地平组为84%,两组比较差异有统计学意义(P<0.05),两组治疗前后心率及各项实验室检测结果无显著性变化,不良反应小,均能耐受。结论两组均能有效控制血压,但氨氯地平与替米沙坦联合应用短期疗效更佳。

Objective To study the effect of combined treatment with amlodipine and telmisartan on primary hypertesion,with amlodipine and amiloride as control.Methods 50 patients with hypertension,who had a withdrawal period for 2 weeks,were randomly divided into two groups：observation group（amlodipine ＋ telmisartan,amlodipine,2.5mg/d;telmisartan,40mg/d）;control group（amlodipine ＋ compound amiloride,amlodipine,2.5mg/d;compound amiloride：Amiloride 1.25 mg ＋ hydrochlorothiazide 12.5 mg）.After 8 weeks,blood pressure,heart rate,electrolyte,liver and kidney function were detected,and adverse reactions were observed at the same time.Results The systolic and diastolic blood pressure decreased significantly in two groups after treatment（P0.05）,and there was significant difference between two groups（P0.05）.Compared with control group,combined treatment with amlodipine and telmisartan has a higher total effective rate at eight weeks after treament（P0.05）.But heart rate,and other laboratory test results had no significant change after treament.Conclusion Both two kinds of combined treatment can effectively control blood pressure,and combined treatment with amlodipine and telmisartan has a better short-term efficacy.