调压活络方治疗H型高血压的疗效及机制研究

Curative Effect and Mechanism of Hypertension Regulating and Collaterals Activating Prescription in the Treatment of H-Hypertension

目的:观察调压活络方治疗H型高血压的疗效,初步探讨其机制。方法:将2015年3月至2016年2月就治的H型高血压患者94例采用随机数字表法分为2组,每组47例,对照组给予依叶片口服,1片/d;治疗组给予依叶片+调压活络方治疗,1剂/d,持续治疗2个疗程。观察2组治疗效果,检测血管活性物质、血液流变学、氧化应激指标及肾素-血管紧张素Ⅱ-醛固酮(Renin AngiotensinⅡAldosterone System,RAAS)系统变化。结果:1)治疗组治疗后除了气短、乏力、善忘积分外,其余症候积分及总分下降幅度均大于对照组,差异有统计学意义(P<0.05);2)治疗后治疗组日间收缩压、舒张压及晚间收缩压、舒张压下降幅度大于对照组,差异有统计学意义(P<0.05);2组治疗后高同型半胱氨酸(Homocysteine,Hcy)浓度比较差异无统计学意义(P>0.05);3)治疗组治疗后RA、AngⅡ低于对照,差异有统计学意义(P<0.05);4)2组治疗后丙二醛(Malondialdehyde,MDA)、髓过氧化物酶(myeloperoxidase,MPO)、氧化物歧化酶(Superoxide Dismutase,SOD)与治疗前比较差异无统计学意义(P>0.05);5)治疗组治疗后前列环素(Prostacyclin,PGI2)低于对照组,而血栓素(Thromboxane A2,TXA2)高于对照组,差异有统计学意义(P<0.05);6)治疗组治疗后血小板活化因子、血小板凝聚率、全血黏度高切均低于对照组,差异有统计学意义(P<0.05)。结论:调压活络方可有效控制H型高血压患者血压,改善症状,值得临床推广适用;其机制可能与调节RAAS系统、保护内皮细胞及减少血液黏稠度有关。

Objective：To observe the effect and mechanism of Hypertension Regulating and Collaterals Activating Prescription in the treatment of H-hypertension.Methods：A total of 94 patients with H-hypertension in March 2015 to February 2016, were divided into two groups by random number table method, 47 cases in each group, the control group was treated with blade, 1 piece/d;while the study group treated with blade ＋ Hypertension Regulating and Collaterals Activating Prescription, once a day, treatment lasted for two courses.The effect, vascular active substances, blood rheology, oxidative stress indicators and renin-angiotensin Ⅱ-aldosterone system （RAAS） changes were observed.Results：1） After the treatment, the study group had significantly better results in symptoms score and total scores than the control group expect for shortness of breath, fatigue, forgetfulness （P〈0.05）;2） After the treatment, the day and late systolic pressure, diastolic blood pressure and systolic blood pressure, diastolic blood pressure of the study group met a significantly greater drop than the control group （P〈0.05）;Hcy concentration had no statistical significance （P〉0.05）;3） RA, Ang Ⅱ in the study group were significantly lower than the control group （P〈0.05）;4） There were no statistically significant differences in MDA, MPO, SOD between two groups （P〉0.05）;5） After treatment, PGI2 in the study group was lower than the control group, and TXA2 was higher, the differences were statistically significant （P〈0.05）;6） platelet activating factors, platelet aggregation rate, whole blood viscosity, high shear in the study group were lower than that in the control group, the differences were statistically significant （P〈0.05）.Conclusion：Hypertension Regulating and Collaterals Activating Prescription can effectively control the blood pressure, and improve symptoms in the treatment of H-hypertension, which is worthy of clinical promotion.The mechanism may be related to regulating RAAS system, protecting endothelial cells and reducing blood viscosity.