温胆汤联合依那普利片治疗H型高血压(痰浊内蕴型)的临床观察

Clinical Observation on Wendan Decoction Combined with Enalapril in the Treatment of H Type Hypertension(Phlegm Turbid Type)

目的观察温胆汤联合依那普利治疗H型高血压(痰浊内蕴型)的临床疗效及安全性。方法将80例H型高血压患者随机分为对照组与联合组,各组40例。对照组患者给予依那普利片治疗,联合组在对照组基础上联合温胆汤进行治疗。考察2组患者的血压变化、血浆同型半胱氨酸(homocysteine, Hcy)与炎症因子水平、中医临床疗效、肝肾功能性指标及药物不良反应。结果治疗后联合组患者临床总有效率明显高于对照组(P<0.05);联合组患者收缩压、舒张压、Hcy水平比对照组明显降低(P <0.05),血浆炎症因子TNF-α、Hs-CRP及IL-6含量亦明显减少(P<0.05)。与治疗前比较,治疗后联合组中上述指标均得到明显改善(P<0.05)。安全性方面,患者肝功能(ALT、AST)与肾功能(Cr、BUN)在治疗前后均无明显差异(P>0.05),且2组均未见不良反应。结论温胆汤可安全有效地协助依那普利控制血压及炎症,降低Hcy水平、减轻临床症状,继而为其"从痰论治"奠定临床基础,为中西医结合治疗H型高血压提供新思路。

Objective To study the clinical effectiveness and safety of Wendan decoction combined with enalapril for treating typeHhypertension （phlegm turbid type）. Methods 80 cases of patients with type H hypertension （phlegm turbid type） , according to theorder of admission number taken, randomly were divided into control group （n=40） and combined group （n=40） . The patients incontrol group were administrated with enalapril, while the combined group was simultaneously given Wendan decoction and enalapril.After 8 weeks, the levels of systolic pressure, diastolic pressure, Hcy, inflammatory cytokines, ALT, AST, Cr, BUN and TCM clinicaleffect evaluation before and after the treatments were studied. Results The blood pressure, Hcy, TNF-α Hs-CRP and IL-6 levels weresignificantly reduced in combined group when comparing with controlled group. Moreover, the treatment using Wendan decoctioncombined with enalapril exerted notable therapeutic advantage and excellent safety. Conclusion The application of the enalaprilcombined with Wendan decoction for patients with type H hypertension is beneficial to improve the effect of enalapril in bloodpressure, inflammation and Hcy control, improve the clinical efficiency. Nevertheless, the adverse reactions are unconspicuous. Thusit can lay the foundation for ＂ treatment according to phlegm differentiation＂ , and provide the therapeutic strategies penetrated fromintegrated traditional Chinese and Western medicines.