时间治疗学对非杓型高血压患者降压疗效的临床研究

Clinical study of anti-hypertensive effects of different dosing time in patients with non-dipper hypertension

目的探讨不同服药方法对非杓型高血压患者降压疗效的影响。方法 48例非杓型高血压患者随机分为早上顿服组(24例)和分次服用组(24例),使用药物为非洛地平缓释片和培哚普利片,用药8周,观察用药前后24h动态血压参数,并比较两组患者血压昼夜节律的变化。结果服药8周后,与早上顿服相比较,分次服用降压药物能使患者取得了更好的降压效果(t分别=4.45、2.38,P<0.05)。此外,早晚分次给药患者的血压昼夜节律由非杓型恢复为杓型的显著多于早晨顿服组,差异具有统计学意义(χ2=10.10,P<0.05)。结论联合长效降压药物治疗2级和3级非杓型高血压患者,早晚分次给药与早晨顿服相比,降压效果更好、降压更加平稳,有利于血压的昼夜节律由非杓型恢复为正常的杓型。

Objective To investigate anti-hypertensive effects of different dosing time in patients with non-dipper hypertension.Methods A total of 48 patients with non-dipper hypertensive were randomly divided into two groups.Patients in group A（n=24） took felodipine sustained release tablet and perindopril tablet qd at 7 o＇clock.Patients in group B（n=24） took felodipine sustained release tablet qd at 7 o＇clock and perindopril tablet qd at 19 o＇clock.The change of 24 hours BP and blood pressure diurnal rhythm before treatment and 8 weeks later were compared.Results The decrease of mean systolic blood pressure and mean diastolic blood pressure in group B were significantly larger than those in group A after 8 weeks treatment（t=4.45,2.38,P 0.05）.Furthermore,the circadian rhythm of blood pressure was changed from non-dipper to dipper at 18 case patients in group B after treatment,which was 7 in group A（χ2=10.10,P0.05）.Conclusions Compared one time a day with two time a day,the method of taking medicine with combination long-effect antihypertensive drugs was better for the patients with non-dipper hypertension;blood pressure drop was more stable,and the circadian rhythm of blood pressure was better to resume to normal.