滋阴潜阳辨证治疗顽固性高血压合并颈动脉粥样硬化相关指标及疗效观察

Study on Nourishing Yin for Suppressing Hyperactive Yang in Treatment of Refractory Hypertension with Carotid Atherosclerosis Patients' Related Factors and Its Effect

目的:探讨滋阴潜阳辨证治疗顽固性高血压合并颈动脉粥样硬化患者NO、CGRP以及生存质量的影响。方法:选取医院2013年8月—2016年1月收治的顽固性高血压合并颈动脉粥样硬化患者84例,按随机数字表法分组,分别42例,对照组予以降压、稳定斑块治疗;研究组在降压、稳定斑块基础上予以滋阴潜阳辨证治疗,共治疗2个月为1疗程,采血测定炎症因子以及血管内皮功能,超声观察颈动脉粥样硬化斑块改变,记录SF-36生存质量,同时对比临床疗效。结果:与治疗前比较,两组治疗后FMD升高,斑块Crouse积分、IMT降低,治疗后生理功能、总体健康、活力、社会功能、精神健康评分升高,治疗后IL-6、CRP、vWF含量降低,治疗后ET降低,NO、CGRP含量升高(P<0.05);与对照组比较,研究组治疗后FMD较高,斑块Crouse积分、IMT较低,治疗后生理功能、总体健康、活力、社会功能、精神健康评分较高,治疗后IL-6、CRP、vWF含量较低,治疗后ET较低,NO、CGRP含量较高(P<0.05);对照组有效率71.43%与研究组有效率90.48%数据对比,研究组高于对照组(P<0.05)。结论:滋阴潜阳辨证治疗顽固性高血压合并颈动脉粥样硬化疗效确切,稳定斑块,改善内皮功能及炎症指标,提高生存质量。

Objective：To investigate the effect of nourishing yin for suppressing hyperactive yang in the treatment of refractory hypertension with carotid atherosclerosis in patients’ serum NO,CGRP and quality of life.Methods：Eighty-four patients with refractory hypertension complicated with carotid atherosclerosis in our hospital from August 2013 to January 2016 were selected and randomly divided into 2 groups,42 cases in each respectively.The control group received antihypertensive,stable plaque treatment and the study group were treated more with nourishing yin for suppressing hyperactive yang treatment,and patients were treated for 2 months.Inflammatory cytokines and vascular endothelial function were determined in serum,changes of carotid atherosclerotic plaque were detected by Doppler ultrasound,and the quality of life of SF-36,and the clinical efficacy were compared.Results：Compared with before treatment,levels of FMD in 2 groups increased after treatment;levels of plaque Crouse integral and IMT decreased;scores of physiological function,general health,vitality,social function and mental health incresed after treatment;levels of IL-6,CRP and vWF decreased after treatment;levels of ET decreased;levels of NO and CGRP increased（P〈0.05）.Compared with the control group,levels of FMD in the study group were higher;levels of plaque Crouse integral and IMT were lower;scores of physiological function,general health,vitality,social function and mental health were higher;levels of IL-6,CRP and vWF were lower;levels of ET were lower,levels of NO and CGRP were higher（P〈0.05）.The effective rate in the control group（71.43%） was lower than the study group’s（90.48%）（P〈0.05）.Conclusion：Nourishing yin for suppressing hyperactive yang in the treatment of refractory hypertension with carotid atherosclerosis has curative effective.It can improve endothelial function and inflammatory factors and the quality of life.