清脑汤治疗H型高血压的临床疗效观察

An observation of clinical effect of Qingnao decoction in treatment of H type hypertension

目的观察清脑汤治疗H型高血压的临床疗效。方法将本院收治的60例原发性H型高血压患者按随机原则分对照组和治疗组，每组30例。对照组给予非洛地平缓释片5mg口服，治疗组给予清脑汤（陈皮10g，半夏10g，茯苓12g，甘草6g，天竺黄10g，胆南星6g，石菖蒲10g，郁金10g），均7d为1个疗程，共用4个疗程。观察两组治疗前后24h动态血压变化、同型半胱氨酸（Hcy）水平及中医证候疗效。结果两组治疗前收缩压（SBP）、舒张压（DBP）、Hcy比较差异均无统计学意义（均P〉0．05）；治疗后均较治疗前明显降低，且以治疗组降低更显著[SBP（mmHg，1mmHg=0．133kPa）：日间138．6±12．9比148．4±13．2，夜间128．6±9．7比137．2±10．5，24h135．4±11．0比142．1±11．6；DBP（mmHg）：日间91．4±7．8比97.3±8．9，夜间83．8±7．6比89．2±8．0，24h88．3±8．1比95．9±7．5，均P〈0．05]；对照组治疗后Hcy水平无明显变化，治疗组治疗后明显降低，且治疗组明显低于对照组（μmaol／L：15．3±2．9比18．8±3．5，P〈0．05）。虽然治疗组有效率与对照组比较差异无统计学意义[40．0％（12／30）比40．0％（12／30），P〉0．05]，但治疗组显效率、总有效率均明显高于对照组[显效率：53．3％（16／30）比43．3％（13／30），总有效率：93．3％（28／30）比83．3％（25／30），均P〈0．05]。结论中药清脑汤治疗原发性H型高血压患者能改善临床症状，降低血压和Hcy。

Objective To observe the clinical effect of Qingnao decoction in the treatment of H type hypertension. Methods Sixty patients in our hospital with primary H type hypertension were randomly divided into a treatment group and a control group （each, 30 cases） . The control group was treated with slow released tablet felodipine 5 mg orally, while the treatment group was given Qingnao decoction （including following ingredients ： dried orange peel 10 g, tuber of pinellia 10 g, poria 12 g, licorice 6 g, concretio silicea bambusae 10 g, bile arisaema 6 g, Rhizoma acori graminei 10 g, curcuma longa 10 g）,7 days for 1 course, totally for 4 courses. Before and after treatment, the changes of 24-hour dynamic blood pressure, the level of homocysteine （Hcy） and therapeutic effects of traditional Chinese medicine syndrome in the two groups were observed. Results Before treatment, there were no statistical significant differences in systolic blood pressure （SBP）, diastolic blood pressure （DBP） and the level of Hcy between the two groups （all P〉0.05） ; after treatment they were significantly lower than those before treatment in the two groups, and the range of decrease was more obvious in the treatment group than that in the control group [ SBP （mm Hg, 1 mm Hg=0.133 kPa） ： the day ： 138.6±12.9 vs. 148.4±13.2, night ： 128.6±9.7 vs. 137.2±10.5,24 hours ： 135.4± 11.0 vs. 142.1 ± 11.6 ; DBP （mm Hg） ： the day ： 91.4±7.8 vs. 97.3±8.9, night ： 83.8±7.6 vs. 89.2±8.0, 24 hours ： 88.3±8.1 vs. 95.9± 7.5, all P〈0.05 ]. After treatment, Hcy had no significant changes in the control group, while in the treatment group, it was decreased significantly after treatment, the level in the latter group being markedly lower than that of the former group （μmol/L ： 15.3±2.9 vs. 18.8±3.5, P〈0.05）. Although there was no statistical significant difference in effective rate between the treatment group and control group [40.0% （12/30）vs. 40.0% （12/30）, P〉0.053, the significant effective rate and the total effective rate of the treatment group were significantly higher than those in control group [ significant effective rate ： 53.3% （16/30） vs. 43.3% （13/30）, the total effective rate ：93.3% （28/30）vs. 83.3% （25/30）, both P〈0.05]. Conclusion Qingnao decoction can improve clinical symptoms, decrease blood pressure and the level of Hcy in primary H type hypertension.