解郁平肝汤治疗高血压合并焦虑症肝郁化火型的临床观察

Clinical Observation on Jieyu Pinggan Decoction in the Treatment of Hypertensive Patients with Anxiety of Liver Depression Transforming into Fire

目的:观察解郁平肝汤治疗高血压合并焦虑症肝郁化火型患者的临床疗效。方法:选取2014年10月至2016年9月在重庆市九龙坡区中医院就诊且符合试验标准的70例患者随机分为治疗组(35例)和对照组(35例),2组均给予依那普利降压治疗,治疗组联合中药复方解郁平肝汤抗焦虑治疗,对照组则联合黛力新抗焦虑治疗,治疗后比较2组中医证候疗效评分、动态血压、SAS评分,去甲肾上腺素(NE)、AngⅡ、内皮素测定及安全性情况研究。结果:2组治疗后SAS量表评分均得到改善,2组治疗后水平比较,差异无统计学意义(P>0.05);治疗后2组中医症候疗效评分均有改善,2组治疗后水平比较,差异无统计学意义(P>0.05);治疗后治疗组中医症候评分有效率为91%,显著高于对照组的74%,差异有统计学意义(P<0.01);2组治疗前后血管紧张素Ⅱ、去甲肾上腺素、内皮素水平均变化显著(P<0.01),且治疗组治疗后内皮素水平显著低于对照组,差异有统计学意义(P<0.05);治疗后,患者白昼SBP、DBP、夜间SBP、夜间DBP降低差异有统计学意义(P<0.01);治疗组各指标水平更低,差异有统计学意义(P<0.05)。结论:解郁平肝汤在改善焦虑与黛力新疗效相似,均可降低去甲肾上腺素、血管紧张素Ⅱ水平,但解郁平肝汤对于改善肝郁化火的相关症状/协助控制血压方面及降低血管内皮素疗效更好。

Objective： To observe the clinical effect of Jieyu Pinggan Decoction in the treatment of hypertensive patients with anxie- ty of liver depression transforming into fire. Methods ： A total of 72 patients in our hospital who meet the trial standard from Octo- ber 2014 to September 2016 were randomly divided into treatment group （36 cases） and control group （36 cases）. Patients in the two groups were all given enalapril antihypertensive treatment. In addition, patients in the treatment group were also treated with anti-anxiety treatment of Jieyu Pinggan Decoction, and patients in the control group were given Deanxit anti-anxiety treatment. Af- ter treatment, the Chinese medicine symptom curative effect score, ambulatory blood pressure, SAS score, noradrenaline （ NE）, Ang II, endothelin testing and security of the two groups were compared. Results ： There was no significant difference in the SAS score and Chinese medicine symptom curative effect score of the two groups before and after treatment （ P 〈 0. 01 ）. In the treat- ment group, the effective rate of Chinese medicine symptom curative score was 91% , which was significantly higher than that of the control group （74%） （P 〈 0. 01 ）. The levels of Ang II, norepinephrine and endothelin of the two groups before and after treatment changed significantly （P 〈 O. 01 ）, and after treatment, the level of endothelin in the treatment group were significantly lower than that of the control group （P 〈 0. 05 ）. After treatment, the SBP and DBP of patients in daytime and night were all re- duced （P 〈 0. 01 ）. The levels of several indexes in the treatment group were lower than those of the control group （ P 〈 0. 05 ）. Conclusion：Jieyu Pinggan Decoction plays a similar role in improving anxiety with Deanxit, and it can reduce the levels of norepi- nephrine and Ang II. However, Jieyu Pinggan Decoction has a better curative effect in improving symptoms related to liver depression transforming into fire, helping control blood pressure and reducing vascular endothelin.