天麻钩藤饮对H型高血压左室肥厚患者心功能指标及主要心血管事件的影响

Effect of Tianma Gouteng Decoction on index of heart function and major cardiovascular events in treatment of H-type hypertension patients with left ventricular hypertrophy

目的探究天麻钩藤饮对H型高血压左室肥厚患者心功能指标及主要心血管事件（非致死性心肌梗塞、脑卒中及心血管疾病死亡）的影响。方法选取2014年1月~2014年5月辽阳市第三医院循环内科治疗的H型高血压左室肥厚患者126例,按随机数字表法分为观察组和对照组,每组各63例。对照组给予常规西药治疗,观察组在对照组的基础上给予天麻钩藤饮治疗。记录并比较2组同型半胱氨酸（plasma homocysteine,Hcy）水平、左室射血分数（left ventricular ejection fraction,LVEF）、早期与晚期二尖瓣血流峰速比值（E/A）及主要心血管事件的发生率的差异。结果与治疗前相比,治疗后2组Hcy水平均显著降低,观察组效果更佳（P〈0.05）。治疗后,2组患者E/A比值及LVEF均显著提高（P〈0.05）;观察组E/A比值及LVEF显著高于对照组（P〈0.05）。随访过程中,观察组主要心血管事件发生率显著低于对照组（6.35%VS 19.05%）（P〈0.05）。结论天麻钩藤饮可显著降低H型高血压左室肥厚患者Hcy水平,提高左心室舒张及收缩功能同时可对主要心血管事件的发生起到积极的预防作用。

Objective To explore the changes of index of heart function and major cardiovascular events（ nonfatal myocardial infarction,stroke,and cardiovascular death） to H-type hypertension patients with left ventricular hypertrophy caused by Tianma Gouteng Decoction. Methods 126 H-type hypertension patients with left ventricular hypertrophy from January 2014 to May 2014 in our hospital were divided into observation group and control group,63 cases in each group. Control group was treated with conventional western medicine,observation group was treated with Tianma Gouteng Decoction on the basis of control group. The levels of plasma homocysteine（ Hcy）,left ventricular ejection fraction（ LVEF）,the E / A,and the incidence of major cardiovascular events were recorded and compared between the two groups. Results Compared with pre-treatment,the levels of Hcy in the two groups were significantly decreased（ P〈0. 05）,and the effect of observation group was better（ P〈0. 05）. After the treatment,the E / A and LVEF of the two groups were significantly improved（ P〈0. 05）; the E / A ratio and LVEF in observation group were significantly higher than those in control group（ P〈0. 05）. The incidence of major cardiovascular events in observation group was significantly lower than that in control group（ 6. 35%VS 19. 05%,P〈0. 05）. Conclusion Tianma Gouteng Decoction can significantly reduce the Hcy of patients who get H-type hypertension,improve diastolic and systolic function and lower the occurrence of major cardiovascular events.