EECP联合中西医疗法治疗高血压的临床疗效及对ET、NO、AngⅡ的影响

Clinical Curative Effect and Change of ET,NO and AngⅡ after the Treatment of Hypertension by TCM Combined with Western Medicine with EECP

目的观察增强型体外反搏(EECP)联合中西医结合治疗痰瘀互结型高血压的临床疗效及其对内皮素(ET)、一氧化氮(NO)和血管紧张素Ⅱ(AngⅡ)的影响,并对其治疗高血压的机制进行探讨分析。方法选取辨证为痰瘀互结型高血压患者160例,随机分为治疗组和对照组,各80例。治疗组为常规西药及中药基础上联合EECP治疗,疗程为30 d,每日1次,每次60 min。对照组为常规西药加用中药治疗。两组分别在第1次反搏前的10 min内、最后1次反搏结束后的10 min内采集血液样本并进行ET-1、NO及AngⅡ含量的测定。同时记录两组患者治疗前后高血压情况、中医症状的变化情况。结果治疗组的临床降压疗效和中医证候疗效总有效率均显著高于对照组(P<0.05)。治疗后,两组患者ET-1、AngⅡ较治疗前明显下降(P<0.05);且治疗组含量均显著低于对照组(P<0.05)。两组患者NO较治疗前明显增加(P<0.05);且治疗组显著高于对照组(P<0.05)。结论 EECP联合中西医结合治疗痰瘀互结型高血压具有明确的降压及改善中医证候的疗效,其机制与降低血清中ET-1、AngⅡ含量及增加血清中NO含量,进而改善血管内皮功能密切相关。增强型体外反搏联合中西医结合治疗高血压具有较好的安全性及依从性。

Objective： To observe the clinical curative effect and the change of ET,NO and Ang Ⅱ after the treatment of the phlegm turbidity combined with blood stasis type of Hypertension by traditional Chinese medicine （TCM） combined with western medicine with enhanced external counterpulsation （EECP） and discuss and analyze its action mechanism. Methods： 160 cases with phlegm turbidity and blood stasis syndrome differentiation type of hypertension were randomly divided into the treatment group （EECP group） and the control group, 80 cases in each group. The control group was treated by the conventional western medicine combined with TCM .While the treatment group received EECP therapy on the basis of it,once a day,60 minutes every time,lasting for 30 days. Blood samples were collected and the content of ET-1, NO and Ang Ⅱ was measured in both groups within 10 minutes before the first counterpulsation,and 10 minutes after the last counterpulsation. At the same time,the situation and the TCM symptoms of the two groups were recorded before and after the treatment. Results： The antihypersive effects and the efficacy of TCM syndrome integral of the treatment group were higher than that of the control group. The differences between them were significant （P〈 0.05）. After the treatment,the content of ET-1 and Ang Ⅱ in each groups were significantly lower （P〈 0.05）;but the ET-1 and Ang Ⅱ content of the treatment group were significantly lower than that of the control group （P〈 0.05 ）. Meanwhile the NO content of each groups significantly increased after treatment（P〈 0.05 ）;but the NO content of the treatment group was significantly higher than that of the control group （P 〈 0.05）. Conclusion： The treatment of the phlegm turbidity combined with blood stasis type of hypertension by TCM combined with western medicine with EECP has exact effect in controlling the blood pressure and improving the TCM syndrome. And its action mechanism is related to improving endothelial function by changing the content of ET-1 ,NO and Ang Ⅱ. This therapy has very high safety and patient compliance, so the EECP should be used widely.