中西医结合治疗方案对老年高血压患者生活质量的影响观察

Effects of Combined Treatment of Chinese and Western Medicine on the Quality of Life of Elderly Patients with Hypertension

目的:观察中西医结合治疗方案对老年高血压患者生活质量的影响。方法:130例老年高血压患者随机分为观察组与对照组。对照组采用西医治疗,观察组在其基础上实施中医辨证治疗(痰瘀阻络型1号方、阴虚阳亢型2号方、肾虚型3号方)。连续观察6个月,比较两组治疗前后24 h动态血压监测(ABPM)、生活质量和临床体征。结果:两组治疗后ABPM各血压目标值均较治疗前显著下降(P<0.01),两组间差异无统计学意义(P>0.05)。与治疗前比较,观察组的躯体化症状、工作状态、睡眠状况、强迫状况、生理症状评分及总分均有明显改善(P<0.05),而对照组仅生理症状评分有明显改善(P<0.05)。治疗后观察组较对照组在躯体化症状、睡眠状况、人际关系敏感、压抑、强迫状况、敌对、生理症状及总分等方面的改善更为显著(P<0.05或P<0.01)。结论:在西医基础治疗上辨证加服中药治疗方案可以明显改善患者的生理症状、躯体化症状、强迫状况、压抑、睡眠状况、人际关系敏感、敌对等方面积分,提高患者的生活质量和改善预后症状。

Objective ： To evaluate the effects of the combination of TCM with western medicine on the quality of life of elderly patients with hypertension. Methods： A multi-center randomized controlled investigation was performed. Totally 130 cases were equally divided into the test group and the control group. The control group was given western medicine treatment, and the test group was additionally treated with Chinese medicine based on syndrome differentiation （ phlegm and blood obstruction group, yin deficiency with yang hyperactivity group and kidney deficiency group respectively called 1,2 and 3 prescription）. The patients were observed for continuous 6 months, and 24h ABPM, the quality of life and clinical syndrome before and after the treatment were compared between the groups. Results ： The ABPM values of the two groups decreased obviously when compared with those before the treatment（ P 〈 0.01 ） with statis- tically significant differences （ P 〉 0.05 ）. Before and after the treatment in the test group, the changes of physical symptoms, sleep conditions, forced status, working status and physiological symptoms were statistically significant （ P 〈 0.05 ）. The improvements in physiological functions, sleeping, sensitivity about people relationship, depression, hostility, oblige symptom, somatization symptom and collection value in the test group were much better than those in the control group （P 〈 0.05 or P 〈 0.01 ）. Conclusion： The value of collection, sleeping, hostility, depression, sensitivity about people relationship, physiological functions, somatization symptom and oblige symptom et al are all improved after the combined treatment of TCM and western medicine resulting in better quality of life and prognosis.