缬沙坦单药与缬沙坦联合苯磺酸氨氯地平对高血压患者的疗效分析

Effects of valsartan monotherapy and valsartan combined with amlodipine besylate in the treatment of hypertension

目的观察缬沙坦联合苯磺酸氨氯地平对高血压患者治疗的临床效果及安全性。方法选取156例高血压患者按入院顺序随机分为2组,对照组76例患者采用缬沙坦80 mg口服,1次/d,观察组80例患者在对照组基础上采用苯磺酸氨氯地平5 mg口服,1次/d,两组患者均治疗6周。对两组患者治疗前后血压、心率、血脂、血糖等进行测定,并根据治疗前后血压下降情况进行疗效评定。同时在治疗期间严密监测两组患者肝肾功能,记录两组患者药物不良反应发生情况。随访两组患者18个月,观察两组患者靶器官损害及心脑血管事件发生情况。结果两组患者治疗前血压比较差异无统计学意义(P>0.05),治疗后两组患者血压均较治疗前明显下降,且观察组治疗后血压均明显低于对照组(P<0.05)。两组患者治疗前后心率比较差异无统计学意义(P>0.05)。观察组治疗总有效率为95.00%,对照组为81.58%,观察组疗效明显优于对照组(P<0.05)。观察组2例(2.50%)出现轻微头痛,对照组1例(1.32%)出现头晕,均无其他严重不良反应发生,两组患者不良反应发生率比较差异无统计学意义(P>0.05)。观察组1例(1.25%)肾功能轻度损害,对照组2例(2.63%)肾功能轻度损害,1例(1.32%)Ⅰ级心功能不全,观察组靶器官损害及心脑血管事件发生率略低于对照组,但两组比较差异无统计学意义(P>0.05)。结论缬沙坦联合苯磺酸氨氯地平治疗高血压,降压效果明显优于单用缬沙坦,并不增加不良反应,而且可降低靶器官损害及心脑血管事件的发生。

Objective To observe the clinical efficacy mad safety on hypertensive patients treated with valsar- tan and valsartan combined with amlodipine besylate. Methods 156 hypertension patients were randomly divided into 2 groups according to the sequence of admission, control groups （ n = 76） was treated with valsartan 80 mg orally, once a day, while observation group （ n = 80） was treated with amlodipine besylate 5 mg orally, once a day on the basis of control group, all patients were treated for 6 weeks. The blood pressure, heart rate, blood lipids ,blood glucose etc of the two groups before and after treatment were measured, and the efficacy was evaluated according to the blood pressure situation before and after treatment. While the liver and kidney function of the two groups were closely monitored dur- ing the treatment, the occurrence of adverse drug reactions of the two groups were carefully observed and recorded. Two groups of patients were followed up for 18 months, target organ damage, cardiovascular and cerebrovascular events were observed. Results There was no significant difference in blood pressure before treatment between the two groups （P 〉 0. 05 ）. After treatment, the blood pressure of the two groups were significantly decreased, and the treatment group de- creased significantly than the control group （ P 〈 0. 05 ）. There was no significant different of heart rate change before and after treatment （ P 〉 0. 05 ）. The total effective rate of observation group and control group were 95.00% and 81.58 % , the observation group was significantly better than those of the control group （P 〈 0. 05 ）. Observation group had 2 cases （2. 50% ） mild headache,control group had 1 cases （1.32%） dizziness,there was no serious adverse reac- tions of the two groups, the incidence of adverse reactions of the two groups had no significant difference （ P 〉 0. 05 ）. Observation group had 1 case （ 1.25% ） mild renal damage,control group had 2 cases （2. 63% ） mild renal damage, one case （ 1.32% ） I -class cardiac insufficiency, the target organ damage, cardiovascular and cerebrovascular events incidence of observation group were slightly lower than the control group, but there was no significant difference be- tween the two groups （ P 〉 0. 05 ）. Conclusion Valsartan combined with amlodipine besylate has decreased blood pressure obviously than valsartan alone ,does not increase adverse reactions ,and can reduce the target organ damage and cardiovascular events.