潜阳合剂加载对老年高血压病患者脉压差及血压晨峰的影响

Effect of added therapy with Qianyang Heji Decoction on pulse pressure and morning blood pressure surge of elder hypertensive patients

目的观察常规西药基础上加载潜阳合剂(地黄、钩藤、牡蛎等)治疗对老年高血压病患者脉压差及高血压晨峰的影响。方法将112例患者随机分为治疗组和对照组,对照组用常规抗高血压西药(苯磺酸氨氯地平片,厄贝沙坦片,氢氯噻嗪片),治疗组另加载潜阳合剂。观察治疗前后患者诊室血压、动态血压、症候积分的变化及症候疗效。结果治疗后,治疗组诊室收缩压(SBP)、脉压差(PP)明显低于对照组(P<0.01);治疗组动态血压监测清晨SBP、晨峰程度均明显低于对照组(P<0.01);治疗组中医症候明显改善,总症候积分较对照组有统计学意义(P<0.01);治疗组中医症候总有效率83.93%,显著优于对照组(P<0.01)。结论在西药基础上加载中药潜阳合剂不仅能有效改善老年高血压患者阴虚阳亢症状,且能有效减小其晨峰幅度和脉压差。

AIM To observe the curative effect of added therapy with Qianyang Heji Decoction（Rehmanniae Radix,Uncariae Ramulus cum Uncis,Ostreae concha,etc.） on the basis of conventional western medicines on the pulse pressure（PP） and morning blood pressure surge（MBPS） of elder hypertensive patients.METHODS One hundred and twelve patients,treated with conventional anti-hypertensive western medicines（Amlodipine besylate Tablets,Irbesartan Tablets,Hydrochlorothiazide Tablets）,were randomly assigned into control group and treatment group,the latter added with Qianyang Heji Decoction.Office blood pressure,ambulatory blood pressure（ABP）,changes of clinical symptoms scores and symptoms efficacy were monitored before and after the treatment.RESULTS After treatment,office systolic blood pressure（SBP） and PP monitoring in the treatment group were significantly lower than those of the control group（P〈0.01）;ambulatory blood pressure morning SBP and MBPS degree in the treatment group were significantly lower than those of the control group（P〈0.01）;traditional Chinese medicine（TCM） syndrome of the treatment group was improved significantly and the total syndrome scores had significant differences compared with the control group（P〈0.01）;Total effective rate of TCM symptoms was83.93%,which was significantly better than that of the control group（P〈0.01）.CONCLUSION Added therapy with Qianyang Heji Decoction on the basis of conventional western medicines is not only able to effectively improve in hyperactivity of Yang due to Yin deficiency of elder hypertensive patients,but also to effectively reduce the MBPS amplitude and PP.