黄连阿胶汤加味治疗老年高血压失眠患者的临床观察

Clinical Observation of Modified Huanglian Ejiao Decoction in the Treatment of Elderly Hypertensive Patients with Insomnia

目的:观察黄连阿胶汤加味对老年高血压失眠患者的临床疗效。方法:120例老年高血压伴失眠患者随机均分成对照组和试验组,在常规降压治疗基础上,试验组给予黄连阿胶汤加味,300ml/次,每天2次;对照组给予脑力清丸,10丸/次,每天2次,均以28d为一疗程。记录用药前后患者的匹兹堡睡眠质量指数表(PSQI)评分,动态血压与心肾不交症状改善程度。结果:与对照组比较,试验组PSQI总评分和睡眠质量、睡眠效率、睡眠时间、睡眠障碍、入睡时间评分均显著降低(P<0.05),各动态血压水平无显著性差异(P>0.05);腰膝酸软、舌干而红、潮热盗汗改善程度明显提高,心肾不交症状总评分显著降低(P<0.05)。结论:黄连阿胶汤加味在一定程度上对心肾不交型老年高血压患者的睡眠质量有提高作用并能稳定血压,可为临床此类患者的治疗提供参考。

OBJECTIVE： To observe clinical efficacy of modified Huanglian ejiao decoction in the treatment of elderly hypertensive patients with insomnia. METHODS： 120 elderly hypertensive patients with insomnia of disharmony between heart and kidney were randomly divided into control group and experimental group. On the basis of conventional antihypertensive treatment, the experimental group took modified Huanglian ejiao decoction 300 ml/time twice a day; control group was given Naoliqing pills 10 pills/time twice a day. A treatment course lasted for 28 days. Result of pittsburgh sleep quality （PSQI）, ambulatory blood pressure and symptoms improvement were recorded before and after medication. RESULTS： Total score of PSQI, sleep quality, sleep efficacy, hours of sleep, dyssomnia and sleep latency were all lower in experimental group than in control group significantly （P〈 0.05）; there was no significant difference in ambulatory blood pressure（P〉0.05） ; the improvement of soreness and weakness of waist and knees, dry and red tongue, hot flash and night sweat were improved significantly, and total score of disharmony between heart and kidney were decreased significantly（P〈0.05）. CONCLUSIONS：Modified Huanglian ejiao decoction improves sleep quali- ty of elderly hypertensive patients with disharmony between heart and kidney and keeps stable blood pressure, which provide reliable reference for clinical treatment.