硝苯地平不同给药方式治疗高血压的效果研究

Research on effects of different administration ways with nifedipine on hypertension

目的研究硝苯地平不同给药方式的临床效果。方法临床入选200例原发性高血压患者,按照入院先后顺序编号,随机分成4组,每组50例,分别为硝苯地平片口服治疗组(A组)、硝苯地平片舌下含服治疗组(B组)、硝苯地平片嚼服治疗组(C组)及硝苯地平片粉末鼻腔给药治疗组(D组)。治疗7 d后分析各组的相关临床资料。结果治疗后,4组患者的AUC0-∞、Cmax、Tmax、Vdss/F及Clt两两相比较均具有统计学差异,其中B组的AUC0-∞最大,C组的Cmax及Tmax最大,D组的Vdss/F最大,B组的Clt最小(P<0.05);服药后,B组的收缩压(SBP)、舒张压(DBP)较A组与C组明显降低,降压幅度较A组与C组明显增高(P<0.05);A组和C组不良反应发生率均显著低于B组和D组(P<0.05)。结论硝苯地平片治疗原发性高血压安全有效,其中以舌下含服降压效果最佳,具有起效迅速、维持时间长、作用平缓等优点。

Objective To investigate the clinical effects of different administrations with nifedipine on hypertension. Methods 200 cases of primary hypertension were selected and divided into four groups according to their admission number with 50 cases in each group, including oral treatment with nifedipine group （ group A）, sublingual buccal treatment with nifedipine group （ group B ）,chewing administration treatment with nifedipine group （group C ）, and intranasal administration treatment with nifedipine powder group （group D）. After the treatment for 7 d, the clinical data of each group were analyzed. Results After the treatment, there were significant differents in the AUC0-∞ , C T Vdss/F, and Ch among the four groups （P 〈 0.05 ）. The AUC0-∞ of group B was the largest; the Cmax, and Tmax of group C were the highest and longest ; the Vdss/F of group D was the largest; the Ch of group B was the lowest. After the administration, compared with the SBP and DBP of group A and C, those of group B significantly decreased, and its depressurization range significantly increased compared with that of group A and C（ all P 〈0.05）. The incidences of adverse reactions in group A and C were significantly lower than those in group B and D （P 〈 0.05）. Conclusion Nifedipine is safe and effective in the treatment of primary hypertension. The clinical effect of sublingual buccal treatment is the best, which has advantages of quick curative effect,long time of maintenance, and gentle depressurization effect.