辨证分型中药汤剂联合针刺治疗高血压随机平行对照研究

Syndrome Differentiation Combined with Acupuncture Treatment of Hypertension Randomized Controlled Study

[目的]观察辨证分型中药汤剂联合针刺治疗高血压疗效。[方法]使用随机平行对照方法,将160例门诊患者按就诊顺序号法简单随机分为两组。对照组80例平衡机体水电解质,应用镇静剂、抗组胺药物等;氯沙坦钾氢氯噻嗪,1片/次,1次/d。治疗组80例辨证分型,均1剂/d,水煎400m L,早晚口服,200m L/次;肝肾阴虚-六味地黄汤(熟地15g,山茱萸、山药各12g,丹皮、泽泻、茯苓各10g);针刺:取肾俞、肝俞、三阴交,平补平泻,留针15min,1次/d;肝阳上亢-天麻钩藤饮(天麻90g,川牛膝、钩藤各12g,生决明18g,山栀、杜仲、黄芩、益母草、桑寄生、夜交藤、朱茯神各9g);针剌:取风池、太冲、合谷、肝俞,泻法重刺,留针15min,1次/d;气血亏虚-八珍汤(人参、白术、白茯苓、当归、川芎、白芍药、熟地黄、甘草炙各30g);针刺:取百会、血海、膈俞、足三里、三阴交、气海,补法,留针15min,1次/d;痰湿中阻-半夏白术天麻汤(半夏4.5g,天麻、茯苓、橘红各3g,白术9g,甘草1.5g);针刺:取内关、中脘、丰隆、阴陵泉、头维,平补平泻法,留针15min,1次/d。连续治疗28d为1疗程。观测临床症状、血压、不良反应。治疗1疗程,判定疗效。[结果]治疗组显效44例,有效26例,无效10例,总有效率87.50%。对照组显效24例,有效30例,无效26例,总有效率67.50%。治疗组疗效优于对照组(P<0.01)。血压指标两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]辨证分型中药汤剂联合针刺治疗高血压疗效满意,无严重不良反应,值得推广。

[Objective]Using random parallel control method,160 cases of clinic patients in clinic method simple random divided into two groups.The control group,80 cases of balancing the body water electrolyte,application of sedatives,antihistamines,etc.Losartan Potassiumand Hydrochlorothiazide Tablets,1 piece/times,1 day 1 time.The treatment group 80 cases Syndrome differentiation type,All agent 1/d,boiling water 400 m L,two oral,200 m L/time.Liver and kidney Yin deficiency-Liu Wei Di Huang Tang（Shudi 24 g,Shanyao 12 g,Shanzhuyu 12 g,Fuling,Danpi,Zexie 9g each）;acupuncture： take Shenshu,Sanyinjiao,Ganshu,reinforcing-reducing,retaining needle for 15 minutes,1 day 1 time.Liver Yang syndrone- Tian Ma Gou Teng Yin（Gastrodia 9g,Niuxi1 2g,Gou Teng 12 g,Shengjueming 18 g,Shanz hi,Duzhong,Huangqin,Sangjisheng,Yejiaoteng,Zhufushen 9g each）;acupuncture： take the Fengchi,Taichong,Hegu,Ganshu,heavy barbed reducing method,retaining needle for 15 minutes,1 day 1 time.Deficiency of qi and blood-Ba Zhen Tang（Renshen,Baizhu,Baifuling,Danggui,Chuanxiong,Baishaoyao,Shudihaung,Gancao 30 g each）;acupuncture： Baihui,Xuehai,Geshu,Zusanli,Sanyinjiao,Qihai,tonifying method,retaining needle for 15 minutes,1 day 1 time.The phlegm dampness-Banxia Baizhu Tianma Tang（Banxia 4.5g,Tianma,Fuling,Juhong 3g each,Baizhu 9g,Gancao 1.5g）;acupuncture： take the Neiguan,Fenglon,Zhongwan,Yinlingquan,Touwei,mild reinforcing-reducing method,retaining needle for 15 minutes,1 day 1 time.28 days for a course of treatment.Observation of clinical symptoms,blood pressure and adverse reactions.One course of treatment,to determine efficacy.[Results]The treatment group 44 cases,effective 26 cases,ineffective in 10 cases,the total efficiency of 87.50%.The control group 24 cases markedly effective in 30 cases,26 cases ineffective,the total efficiency of 67.50%.Treatment group than the control group（P〈0.01）.Blood pressure indicators improved in both groups（P〈0.01）,the treatment group than the control group improved（P〈0.01）.[Conclusion]Syndrome Differentiation combined with acupuncture treatment satisfaction Hypertension,no serious adverse reactions,is worth promoting.