自拟补肾和脉方联合硝苯地平片治疗老年高血压合并左室肥厚的临床观察

Clinical Observation on Self – made Pushen Hemai Prescription Combined Nifedipine on the Treatment of Elderly Hypertensive Patients with Left Ventricular Hypertrophy

目的观察自拟补肾和脉方联合硝苯地平片(拜新同)治疗老年原发性高血压的降压疗效和临床症状改善情况,探讨其对心脏左室舒张功能影响。方法将符合诊断标准的患者70例,按随机数字表分成2组,治疗组和对照组,其中治疗组36例,对照组34例。治疗组给予补肾和脉方每日1剂,每剂2袋,每袋200 mL,早晚餐后半小时200 mL温服,同时晨起口服硝苯地平片(拜新同)30 mg1日1次,连用12周。对照组给予晨起口服硝苯地平片(拜新同)30 mg1日1次,连用12周。治疗12周后观察2组患者的24 h动态血压监测参数的变化、症状积分变化、左室舒张功能的变化。结果动态血压,治疗组改善24 h平均收缩压、白天平均收缩压、夜间平均收缩压优于对照组(P<0.05);2组对舒张压的影响无统计学意义。证候积分疗效评价,治疗组症状积分降低优于照组(P<0.05),治疗组症状积分疗效总有效率88.3%,对照组症状积分疗效总有效率44.1%。左室肥厚,治疗组左室舒张末期室间隔厚度(IVST)、左室后壁舒张末期厚度(LVPWT)及左室心肌重量指数(LVMI)均较对照组改善显著,差异均有显著性(P<0.05)。结论补肾和脉方联合硝苯地平片(拜新同)较单用硝苯地平治疗原发性老年高血压病不但可以很好的降压,同时改善患者临床症状,还可以改善患者的左室舒张功能。

Objective： To observe the clinical symptom improvement of elderly essential hypertension patients treated by selfmade Pushen Hemai Prescription combined nifedipine and to explore its effects on left ventricular diastolic function. Methods： 70 patients were randomly divided into two groups. 36 patients in the treatment group were treated with Pushen Hemai Prescription, daily 1 agent, 2 bags per agent, 200 ml, half an hour after morning and evening meal and nifedipine in early morning, daily 30 mg, once, for 12 weeks. 34 patients in the control group were treated with oral nifedipine in the morning, daily 30 mg, once, for 12 weeks. The changes of 24 h ambulatory blood pressure monitoring parameters, symptom score and left ventricular diastolic function of the two groups were observed in the 12 - week treatment. Results： For ambulatory blood pressure, 24 h average systolic pressure, day average systolic pressure and night average pressure of the treatment group improved better than that of the control group （P 〈 0.05 ）. The diastolic blood pressure effects of the two groups were not statistically significant. Symptom score effective evaluation of the treatment group was lower than that of the control group （ P 〈 0.05）. The total effective rate of the treatment group was 88.3% while that of the control group was 44.1%. IVST, LVPWT and LVMI of the treatment group significantly improved when compared with that of the control group, showing significant differences （P 〈 0. 05 ）. Conclusion： Pushen Hemai Prescription combined nifedipine has a better effect on the treatment of elderly essential hypertension patients, improving their clinical symptoms and their left ventricular diastolic function at the same time.