坎地沙坦与红景天联用的降压疗效及其对胰岛素抵抗的影响

Antihypertensive efficacy of candesartan alone or combined with Rhodiola rosea and effect on insulin resistance

目的探讨坎地沙坦与红景天联用的降压效果及其对胰岛素抵抗指数的影响。方法随机将114例高血压病患者分为3组,每组38例。A组:坎地沙坦8 mg,1/d;B组和C组分别为坎地沙坦8 mg,红景天注射液10 ml及15 ml+10%葡萄糖液250 ml;所有患者在治疗前及治疗3个月时取静脉血测血浆葡萄糖(plasma glucose,FPG)、胰岛素(insulin,FINS)。计算胰岛素抵抗指数(insulin resistance index,HOMA-IR)和胰岛素敏感指数(insulin sensitivity index,ISI)。结果治疗3个月后降压有效率B、C两组基本接近,均高于A组,对FPG、FINS、HOMA-IR和ISI的改善C组优于B组,B组优于A组。3组均有抑制或逆转FPG、FPGF、HOMA-IR、ISI作用;3组治疗前FPG、FINS、HOMA-IR、ISI数值接近(P>0.05),治疗前3组的FPG、FINS、HOMA-IR高于治疗后,ISI低于治疗后,差异有显著性(P<0.05);治疗后A组和B组的FPG、FINS、HOMA-IR均降低,ISI升高,抑制或逆转FPG、FPGF、HOMA-IR、ISI作用B组优于A组,C组优于B组和A组,差异有统计学意义(P<0.05)。结论坎地沙坦降压效果肯定,且有改善高血压患者HOMA-IR的作用,联用红景天其作用增强,降低了FPG、FINS和HOMAIR,提高了ISI。高血压合并HOMA-IR者,选用C组治疗值得临床推广。

Objective To investigate antihypertensive efficacy of candesartan alone or combined with Rhodiola rosea and effect on insulin resistance index. Methods A total of 114 patients with hypertension were divided into group A： balance of candesartan 8 mg, 1/day; group B and group C received respectively candesartan and Hongjingtian injection 8 mg, 10 ml and 15 ml＋10% glucose 250 ml, IV drip, 1/day.From all the patierts, before and afler treatment for three months, venous blood plasma was examinations of glucose （FPG）、insulin（FINS）,calculation of insulin resistance index （HOMA-IR） and insulin sensitivity index （ISI）. Results In groups B and C, antihypertensive efficacy was basically close and effect is higher than that in group A. For the improvement of the HOMA -IR and ISI, group C was better than group B, group B was superior to group A. Hypertension patients＇ blood pressure before treatment, FINS and HOMA-IR levels were significantly higher after treatment, the ISI levels significantly lower after treatment （P〈0.05）. After 3 months of candesartan treatment, high blood pressure patients had significantly lower blood pressure, fasting glucose, FINS and lower HOMA-IR , ISI levels （P〈0.05） and there were differences between the three groups. Conclusions Candesartan has certainly antihypertensive effect, and improves the HOMA-IR in hypertensive patients,and combined use of Rhodiola decreases FPG, FINS and HOMA-IR, increases ISI.For hypertension complicated with HOMA-IR, C group of clinical treatment is worthy of spread use.