氨氯地平联合二甲双胍治疗肥胖型轻中度高血压的临床疗效研究

Clinical Effect of Amlodipine Combined With Metformin on Obesity-related Mild or Moderate Hypertension

目的探讨氨氯地平联合二甲双胍治疗肥胖型轻中度高血压的临床疗效。方法选取2013年12月—2015年3月恩施市中心医院收治的肥胖型轻中度高血压患者90例,按照随机数字表法分为观察组、对照A组、对照B组,每组30例。观察组患者给予氨氯地平联合二甲双胍治疗,对照A组患者单纯给予氨氯地平治疗,对照B组患者单纯给予二甲双胍治疗;3组患者均治疗6个月。比较3组患者临床疗效,治疗前后收缩压(SBP)、舒张压(DBP)、体质指数(BMI)、腰臀比(WHR)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、胰岛素敏感指数(ISI)、空腹胰岛素(FINS)。结果观察组患者临床疗效优于对照A组和对照B组(u值分别为2.601、4.048,P值分别为0.009、0.000);对照A组和对照B组患者临床疗效比较,差异无统计学意义(u=1.544,P=0.061)。治疗前3组患者SBP、DBP、BMI、WHR比较,差异无统计学意义(P>0.05);治疗后观察组患者SBP、DBP、BMI、WHR均低于对照A组和对照B组(P<0.05),而治疗后对照A组和对照B组SBP、DBP、BMI、WHR比较,差异无统计学意义(P>0.05)。治疗前3组患者TG、TC、LDL-C、HDL-C比较,差异无统计学意义(P>0.05);治疗后3组患者TG、TC、LDL-C、HDL-C比较,差异有统计学意义(P<0.05)。治疗前3组患者FBG、HbA_(1c)、ISI和FINS比较,差异无统计学意义(P>0.05);治疗后观察组患者FBG、HbA_(1c)、ISI和FINS均低于对照A组和对照B组(P<0.05),而治疗后对照A组和对照B组患者FBG、HbA_(1c)、ISI和FINS比较,差异无统计学意义(P>0.05)。结论氨氯地平联合二甲双胍治疗肥胖型轻中度高血压的临床疗效确切,降压效果稳定,且能减轻体质量、调脂并改善胰岛素抵抗。

Objective To explore the clinical effect of amlodipine combined with metformin on obesity- related mild or moderate hypertension. Methods A total of 90 patients with obesity- related mild or moderate hypertension were selected in the Central Hospital of Enshi from December 2013 to March 2015,and they were divided into A group,B group and C group according to random number table,each of 30 cases. Patients of A group received amlodipine,of B group received metformin,of C group received amlodipine combined with metformin; all of the three group continuously treated for 6 months. Clinical effect,SBP,DBP,BMI,WHR,TG,TC,LDL-C,HDL-C,FBG,HbA1c,ISI and FINS before and after treatment were compared between the two groups. Results The clinical effect of C group was statistically significantly better than that of A group（ u =2. 601,P = 0. 009） and B group（ u = 4. 048, P = 0. 000）, respectively; while no statistically significant differences of clinical effect was found between A group and B group（ u = 1. 544,P = 0. 061）. No statistically significant differences of SBP,DBP,BMI or WHR was found among the three groups before treatment,nor was SBP,DBP,BMI or WHR between A group and B group after treatment（ P〉0. 05）,while SBP,DBP,BMI and WHR of C group were statistically significantly lower than those of A group and B group after treatment（ P〈0. 05）. No statistically significant differences of TG,TC,LDL-C or HDL-C was found among the three groups before treatment（ P〉0. 05）,while there were statistically significant differences of TG,TC,LDL-C and HDL-C among the three groups after treatment（ P〈0. 05）. No statistically significant differences of FBG,HbA1c,ISI or FINS was found among the three groups before treatment,nor was FBG,HbA1c,ISI or FINS between A group and B group after treatment（ P〉0. 05）,while FBG,HbA1c,ISI and FINS of C group were statistically significantly lower than those of A group and B group（ P〈0. 05）. Conclusion Amlodipine combined with metformin has certain clinical effect and stable antihypertensive effect in treating obesity- related mild or moderate hypertension, can effectively reduce the body weight,improve the blood lipid metabolism and relieve the insulin resistance.