中医适宜技术治疗老年原发性高血压的疗效观察

Observation of the treatment effect of appropriate technology of traditional Chinese medicine in the treatment of elderly patients with essential hypertension

目的 :探索采用中医适宜技术治疗社区老年原发性高血压患者的疗效。方法 :收集2016年01月—2017年12月收治的老年原发性高血压患者200例,分为对照组和治疗组各100例。两组均按个体差异给予钙通道阻滞剂(CCB)、血管紧张素转换酶抑制剂(ACEI)、血管紧张素受体阻滞剂(ARB)或β-受体阻滞剂(β-RB)等常规降压药物。治疗组同时辅以中医适宜技术,包括耳穴、足浴和穴位按压。两组均于治疗3个月后评价降压效果,比较两组心脏检测结果、24 h尿微量白蛋白(MAU)阳性率及两组总费用。结果 :治疗组总有效率为95%(95/100),对照组为82%(82/100),治疗组高于对照组(P<0.05)。治疗组西药费用及总费用分别为37 296元,治疗组为32 163元,明显少于对照组(P<0.05)。疗程结束后,心脏超声检查显示两组"无异常"患者数量明显增加(P<0.05)。对照组和治疗组的MAU阳性率分别为35%(35/100)和15%(15/100),治疗组治疗前后差异有统计学意义(P<0.05),治疗组MAU阳性率明显低于对照组(P<0.05)。结论 :中医适宜技术是辅助治疗老年原发性高血压的较好方法,经济安全、疗效显著,值得临床推广。

Objective： To explore the effect of TCM appropriate technology in the treatment of elderly patients with essential hypertension in the community. Methods： From January 2016 to December 2017 200 elderly patients with essential hypertension who were admitted to the Center were selected and divided into a control group and a treatment group with 100 cases each. According to individual differences, the two groups were treated with calcium channel blockers（CCB）, angiotensin converting enzyme inhibitor（ACEI）, angiotensin receptor blocker（ARB） or beta receptor blocker（β-RB） and other antihypertensive drugs. The treatment group was also supplemented with appropriate technology of Chinese medicine, including auricular point, foot bath and acupressure. The effects of hypotension of the two groups were all evaluated after 3 months of treatment. The heart detection results, 24 h urinary micro albumin（MAU） positive rates and the total costs of the two groups were compared. Results： The total effective rate in the treatment group was 95%（95/100）, while that in the control group was 82%（82/100）, and the treatment group was higher than the control group（P〈0.05）. Western medicine cost and total expense of the treatment group were 37,296 Yuan and 32,163 Yuan, respectively, which were significantly less than those of the control group（P〈0.05）. After the course of treatment, echocardiography revealed a significant increase in the number of patients with ＂no abnormalities＂ in both groups（P〈0.05）. The positive rates of MAU in the control group and the treatment group were 35%（35/100） and 15%（15/100）, respectively, and the difference in the treatment group before and after treatment was statistically significant（P〈0.05）, and the positive rate of MAU in the treatment group was significantly lower than that in the control group（P〈0.05）. Conclusion： Appropriate technology of traditional Chinese medicine is a good method to assist the treatment of elderly patients with essential hypertension in the community, which is economical, safe and effective, and worthy of clinical promotion.