中医辨证论治联合生活方式干预治疗正常高值血压224例临床观察

Chinese Medicine Syndrome Differentiation Treatment with Lifestyle Intervention in Treating 224 Cases of High-normal Blood Pressure: a Clinical Observation

目的观察中医辨证论治联合生活方式干预对正常高值血压人群的血压水平及中医证候的影响。方法将336例正常高值血压患者随机分为治疗组224例和对照组112例,对照组采用饮食、运动等各项生活方式干预措施,共干预24个月;治疗组在此基础上根据肝气郁结、痰瘀互结和肝肾阴虚的不同证型分别给予相应中药免煎颗粒口服,每天2次,共治疗12个月,停药后随访12个月。干预前、干预6个月、12个月、24个月时分别检测患者血压水平并进行中医证候评分,干预12个月、24个月时评价患者血压及中医证候积分疗效,同时干预前及干预12个月时进行安全性指标监测。结果干预6个月、12个月及24个月时与本组干预前比较,两组患者中医证候积分、收缩压及治疗组患者舒张压水平均明显降低(P<0.01);治疗组干预后各时间点中医证候积分、收缩压、舒张压水平均低于对照组(P<0.01)。干预12个月时治疗组血压疗效总有效率、高血压病转化率、中医证候积分总有效率分为87.2%、3.7%、84.86%,对照组分别为58.4%、12.9%、35.64%;干预24个月时治疗组分别为84.4%、6.9%、82.11%,对照组分别为56.4%、17.8%、29.70%,两个时间点治疗组疗效均高于对照组,高血压病转化率低于对照组(P<0.01)。治疗后患者安全性指标均未见异常。结论中医辨证论治联合生活方式干预治疗正常高值血压患者降压效果明显,且能安全、有效地改善患者的临床症状。

Objective To observe the effect of Chinese medicine syndrome differentiation treatment with lifestyle intervention on the blood pressure level and syndrome of Chinese medicine of people with high-normal blood pressure. Methods Randomly divided 336 cases with high-normal blood pressure into treatment group （224 cases）, and control group （112 cases）. The control group adopted lifestyle intervention including diet and sporting, for 24 months in total; The treatment group was additionally given corresponding granule of Chinese medicine according to different syndromes of stagnation of liver Qi, intermin-gled phlegm and blood stasis, deficiency of liver-Yin and kidney-Yin,twice everyday, treated for 12 months in total, followed up for 12 months after stopping taking medicine. Examined the blood pressure levels and graded Chinese medicine syndrome before intervention, in the 6th, 12th, 24th month of intervention respectively. Evaluated curative effects on blood pressure and syndrome integration the 12th and 24th month of intervention. Examine the safety indexes before and the 12th month of intervention. Results Compared the 6th, 12th and 24th month of intervention with before treatment of the group, integral of Chinese medicine syndrome and systolic pressure level of patients in both groups and diastolic pressure level of the treatment group all remarkably decreased （ P 〈 0.01 ） ; Integral of Chinese medicine syndrome, systolic pressure level and diastolic pres- sure level of the treatment group at any time point after the intervention were all lower than those of the control group （P 〈0.01）. The total effective rate of blood pressure, hypertension transferring rate and the integral of Chinese medicine syndrome of the treatment group at the 12th month of intervention were 87.2%, 3.7% and 84.86% respec- tively, those of the control group were 58.4%, 12.9% and 35.64% respectively; At the end of 24th month, those of the treatment group were respectively 84.4%, 6.9% and 82. 11% , while those of the control group was 56.4% , 17.8% and 29.70% respectively. The efficacy of the treatment group was all superior to that of the control group at two time points, while hypertension transferring rate was lower than that of the control group （ P 〈 0.01 ）. Safety index of patients in both groups did not show any abnormity. Conclusion Chinese medicine syndrome differentia- tion treatment with lifestyle intervention in treating patients with high-normal blood pressure had remarkable effect on decreasing blood pressure, and could safely and effectively improve clinical symptoms of patients.