辨证分型联合硝苯地平治疗高血压脑血管疾病随机平行对照研究

Syndrome Type Stochastic Parallel Combined with Western Treatment of Hypertension and Cerebrovascular Disease-control Study

[目的]观察辨证分型联合硝苯地平治疗高血压脑血管疾病疗效。[方法]使用随机平行对照方法,将255例门诊患者按就诊顺序号法简单随机分为两组。对照组80例硝苯地平,10mg/次,3次/d。治疗组175例肝阳上亢-平肝潜阳,天麻钩藤饮(天麻、夜交藤、杜仲、菊花、川牛膝、桑寄生各10g,益母草、钩藤后下、白芍各15g,夏枯草20g,石决明30g,地龙6g;头痛重加白蒺藜、川芎各10g;多梦失眠加酸枣仁、黄芩各10g);痰湿中阻-平肝熄风,燥湿化痰,白术半夏天麻汤(半夏、枳实、天麻、白术各10g,陈皮9g,茯苓、泽泻、决明子各15g,远志6g;泛恶、纳减明显加藿香15g,砂仁10g);肝肾阴虚-滋补肝肾,左归丸(熟地24g,山药15g,枸杞、山茱萸、牛膝各12g,菟丝子15g,龟胶烊化6g,生首乌15g,草决明、枳壳各12g);阴阳两虚-滋阴补阳,四君子汤(人参、白术、茯苓各10g,甘草炙5g);均1剂/d,水煎200m L,早晚口服;硝苯地平治疗同对照组。连续治疗14d为1疗程。观测临床症状、血压、血液黏稠度、胆固醇、血脂、脑血流量、不良反应。治疗1疗程,判定疗效。[结果]治疗组显效125例,有效30例,无效20例,总有效率88.57%。对照组显效30例,有效20例,无效30例,总有效率62.50%。治疗组疗效优于对照组(P<0.05)。血脂、黏稠度改善治疗组优于对照组(P<0.01),胆固醇改善两组无明显差异(P>0.05)。大脑中动脉、基底动脉流量改善治疗组优于对照组(P<0.01),椎动脉、大脑前动脉、大脑后动脉流量改善两组无明显差异(P>0.05)。[结论]辨证分型联合硝苯地平治疗高血压脑血管疾病疗效满意,无严重不良反应,值得推广。

[Objective] To observe Syndromes Combined with Western treatment of hypertension and cerebrovascular disease outcome. [Methods]Randomized parallel-group method using the 175 cases of outpatient treatment order number method is simple and randomly divided into two groups. Nifedipine 80 cases in the control group, 10 mg / time, 3 times / d. Treated 175 cases of syndrome type： hyperactivity treatment with calming liver yang, side by Tian ma gou teng yin（Tianma, Yejiaoteng,Duzhong,Juhua,Chuanniuxi,Sangjishe ng 10 g, Yimucao,Gouteng,Baishao 15 g, Xiakucao 20 g, Shijueming 30 g, Dilong 6g; headache heavier Baijili,Chuanxiong 10g; insomnia plus Suanzaoren,Huangqi 10g）; phlegm in the resistance to rule Pinggan Xifeng, dampness and phlegm, Baizhu Banxia Tianma tang（Banxia,Zhishi,Tianma,Dilong 10 g, tangerine peel Chenpi 9g, Fuling,Zexie,Juemingzi 15 g, Yuanzhi 6g; Pan evil, obviously satisfied by adding Huoxiang 15 g, Sharen 10g）; liver and kidney treatment to nourish liver and kidney, side by Zuoguiwan（Shudi 24 g, Shanyao 15 g, Gouqi,Shanzhuyu,Niuxi 12 g, Tusizi 15 g, Guijiao smelt 6g, Shengshouwu 15 g, Caojueming,Zhike 12g）; treatment with nourishing yin and yang yin yang, Sijunzi tang（Renshen,Baizhu,Fuling 10 g, Gancao Sunburn 5g）; both a / d, decoction 200 m L, sooner or later oral. 14 d for a course of continuous treatment. Observation of clinical symptoms, viscosity, cholesterol, lipids, adverse reactions. A course of treatment to determine efficacy. [Results] Treatment group 125 cases, effective 30 cases, 20 cases ineffective, the total efficiency of 88.57%. The control group 30 cases markedly effective in 20 cases, 30 cases, the total efficiency of 62.50%. Treatment group than in the control group（P〈0.05）.[Conclusion]Syndromes Combined with Western treatment of hypertension and cerebrovascular disease effect is significant, it is worth promoting.