麝香保心丸对合并左室肥厚的高血压患者氧化应激反应及血管内皮功能的影响

Effect of Shexiang Baoxin pill on oxidative stress and endothelial dysfunction in patients with hypertension with left ventricular hypertrophy

目的观察麝香保心丸对合并左室肥厚的高血压患者氧化应激反应及血管内皮功能的影响。方法将164例合并左室肥厚的高血压患者随机分为观察组和对照组,每组82例。对照组给予氯沙坦治疗,观察组在对照组的基础上给予麝香保心丸治疗,2组均连续治疗3个月。观察2组治疗前后血压、心率及临床症状变化情况;检测2组治疗前后血管内皮功能指标血清一氧化氮(NO)、内皮素-1(ET-1)水平,肱动脉血流介导内皮依赖性舒张功能(FMD)和内皮非依赖性舒张功能(EID)以及氧化应激相关指标血清超氧化物歧化酶(SOD)、总抗氧化能力(TAC)、丙二醛(MDA)、脂质过氧化物(LPO)水平;记录2组治疗前后左心室后壁厚度(LVPWT)、左室舒张末期内径(LVDd)、室间隔厚度(IVST)及左室质量指数(LVMI)的变化。结果 2组治疗后收缩压、舒张压及心率均明显改善(P均<0.05),2组治疗后比较差异无统计学意义(P均>0.05);2组治疗后心悸、胸闷、胸痛、气促有显著改善(P均<0.05),且观察组改善情况明显优于对照组(P均<0.05);2组治疗后SOD、TAC及NO水平均显著提高(P均<0.05),MDA、LPO及ET-1水平均显著降低(P均<0.05),且观察组上述指标改善情况均明显优于对照组(P均<0.05),观察组FMD、EID改善情况亦优于对照组(P<0.05);2组治疗后LVPWT、LVDd、IVST及LVMI均较治疗前明显下降(P均<0.05),且观察组各指标水平明显低于对照组(P均<0.05)。2组治疗期间均无严重的药物不良反应。结论口服麝香保心丸能够明显改善及抑制高血压患者左室肥厚,缓解患者临床症状,其作用机制可能与降低此类患者的氧化应激反应,改善血管内皮功能有关。

Objective It is to observe the effect of Shexiang Baoxin pill on oxidative stress and endothelial dysfunction in patients with hypertension with left ventricular hypertrophy. Methods 164 patients with hypertension with left ventricular hypertrophy were randomly divided into observation group and control group,each group had 82 cases. The control group was treated with Losartan,the observation group was treated with Shexiang Baoxin pill on the basis of treatment in control group.Both the groups were treated for 3 months. The changes of BP,HR and clinical symptoms,endothelial dysfunction indexes such as NO,ET- 1,brachial artery flow-mediated dilatation（ FMD）,endothlium-independent dilation（ EID） and oxidative stress indexes such as SOD,TAC,MDA,LPO before and after treatment in both groups were observed. The changes of LVPWT,LVDd,IVST and LVMI before and after treatment in both groups were observed. Results HR,SBP and DBP after treatment were significantly improved in both groups（ P〈0. 05）,but there was no significant difference between the two groups after treatment（ P〉0. 05）. The symptoms such as palpitation,chest distress,chest pain,shortness of breath were improved significantly,and the improvements in observation group were better than that in control group（ P〈0. 05）. The levels of SOD,TAC and NO were higher,while that of MDA,LPO and ET- 1 were lower after treatment than those before treatment in both groups（ P〈0. 05）,and the decrease or increase in observation group were more significant（ P〈0. 05）,the improvements of FMD and EID were better in obseration group than that in control group（ P〈0. 05）. The indexes of LVPWT,LVDd,IVST and LVMI were significantly improved in both groups after treatment,and the improvements in observation group were more significant than that in control group（ P〈0. 05）. No severe side effect was found during treatment in both groups. Conclusion Shexiang Baoxin pill can effectively improve ventricular hypertrophy,relieve clinical symptom,and the mechanism may be related with inhibiting oxidative stress and improving endothelial dysfunction