氯沙坦联合硝苯地平治疗老年性高血压的临床疗效观察

To observe the clinical therapeutic effect of losartan combined with nifedipine on senile hypertension

目的 探讨单独及联合使用氯沙坦和硝苯地平治疗老年原发性高血压的临床效果,为临床用药提供依据.方法 将本院收治的老年原发性高血压患者354例随机分为氯沙坦治疗组（A组）、硝苯地平治疗组（B组）和氯沙坦联合硝苯地平治疗组（C组）.其中A组按病情轻重给予氯沙坦钾片50 ～ 100mg/d,B组给予硝苯地平控释片30 mg/d,C组联合使用氯沙坦钾片和硝苯地平控释片,用量与A组和B组相同,每周测量两次血压,持续4周.根据实际疗效调整服药剂量并记录不良药物反应和血压值.疗程结束后统计并分析数据.结果 单独用药组服用氯沙坦钾片和硝苯地平控释片4周后总效率分别达到64.1％和59.0％,而联合用药组总效率达到82.5％,与单独用药比较具有显著差异（x2=5.204,P=0.027;x2=5.734,P=0.019）.降压效果对比,单独用药组之间对比差异无统计学意义（P＞0.05）,而C组与A组比较差异显著（x2=4.233,P=0.016）;C组与B组比较差异显著（x2=7.253,P=0.008）.药物副作用方面氯沙坦组发生率为7.7％,硝苯地平组为15.4％,联合用药组为17.5％,单一用药组间不良反应具有显著差异（P＜0.05）,而单一使用硝苯地平组和联合用药组则无显著差异（P＞0.05）.结论 单一使用氯沙坦和硝苯地平均能在一定程度上降低血压,而联合使用两种药物则能明显提升疗效,且用药合理,安全性高.

Objective To explore the clinical effect of single and combined use of losartan and nifedipine in the treatment of elderly patients with essential hypertension and provide evidence for clinical use of drugs.Methods In our hospital in elderly patients with essential hypertension 354 cases were randomly divided into losartan treatment group （group A）,nifedipine treatment group （group B） and losartan combined with nifedipine treatment group （group C）,in which group A according to the severity of giving Losartan Potassium Tablets 50 100 mg/d,group B given Nifedipine Controlled Realease Tablets 30 mg/d,group C with the use of Losartan Potassium Tablets and Nifedipine Controlled Realease Tablets,the dosage of Group C were the same with group A and group B,measured blood pressure two times in every week,for 4 weeks.According to the actual effect to adjust drug dosage and to record the adverse drug reaction and blood pressure value.After the end of treatment and statistical analysis of data.Results The results of single drug group took Losartan Potassium Tablets and Nifedipine Controlled RealeaseTablets after 4 weeks,total efficiency reached 64.1% and 59.0%,and the total efficiency of the combined treatment group reached to 82.5%,compared with the single drug has significant difference （x 2=5.204,P =0.027; x 2=5.734,P =0.019）.The antihypertensive effect of contrast between the monotherapy group contrast difference was not statistically significant （P 〉0.05） and group C compared with group A had significant difference （x 2=4.233,P 〉0.016） compared with group B and group C significantly （x 2=7.253,P =0.008）.Drug side effects of losartan group,the incidence rate was 7.7%,nifedipine group was 15.4% and the combined treatment group was 17.5%,single drug adverse reaction has significant difference between groups （P 〉0.05） and only use the nifedipine group and combination group with no significant difference （P 〉0.05）.Conclusion The single use of losartan and nifedipine can reduce the blood pressure to a certain extent,and the combined use of the two drugs can significantly improve the curative effect,and using drugs was ratianal and high safty.