天麻钩藤饮对原发性高血压患者动态血压及颈动脉中膜-内膜厚度、左室重构的影响

Evaluation of ambulatory blood pressure and Carotid intima-media thickness and left ventricular remodeling of Tianma Gouteng decoction in patients with essential hypertension

[目的]观察天麻钩藤饮对轻中度原发性高血压患者(肝阳上亢证)降压效果及颈动脉中膜-内膜厚度、左室重构的影响。[方法]将60例轻中度原发性高血压(肝阳上亢证)患者随机分为两组,分别为天麻钩藤饮组(治疗组)和盐酸贝那普利组(对照组),口服治疗各6个月后,检测治疗前后两组患者24 h动态血压水平,计算其血压平滑指数(SI),并检测颈动脉中膜-内膜厚度(IMT),左室重量指数(LVMI)。[结果]研究结果显示,经过6个月的治疗,治疗组治疗前后24 h平均动态收缩压(SBP)差异有统计学意义(P<0.01),白天平均SBP及平均舒张压(DBP)均显著降低(P<0.01),夜间平均SBP及平均DBP均明显降低(P<0.05),白天降幅大于夜间。血压平滑指数:治疗组和对照组患者治疗后均具有较高的平滑指数,两组比较差异无统计学意义。两组治疗前后IMT比较差异有统计学意义(P<0.01),两组治疗后比较差异有统计学意义(P<0.05)。两组治疗前后LVMI差异有统计学意义(P<0.01),两组治疗后比较无统计学差异。[结论]提示天麻钩藤比盐酸贝那普利具有更好的降压作用,具有同样的降压平滑指数,对颈动脉粥样硬化、心脏重构有逆转作用。

[Objective] To research the effect of ambulatory blood pressure and Carotid intima-media thickness and left ventricular remodeling of Tianma Gouteng decoction. [Methods] The study is to divide 60 patients into test group and control group randomly, who were treated with Tianma Gouteng decoction and Benazepril hydrochloride respectively for 6 months. Measure changes of 24 h tendence blood pressure,BP smooth index, intima media thickness （IMT）. [Results] After 6 month＇s therapy, changes of 24 h tendencies blood pressure,either average systolic pressure （SBP） or diastolic pressure （DBP） （P〈0.05） of days or nights, significantly decreased, especially in days P〈0.05） with nights （P〈0.001）. Of smooth index, both of them got high results by SBP and DBP but no significant different. But intima media thickness （IMT） results show significant differency by Tianma Gouteng decoction group （P〈0.05 or P〈0.001）.LVMI results show significantly decreased with the two groups. [Conclusion] This study show that Tianma Gouteng decoction have same efficacy in lowering the 24 h blood pressure, compared with Benazepril hydrochloride, even superior to Benazepril hydrochloride in day BP control and reverse Carotid IMT and left ventricular remodeling.