缬沙坦联合氨氯地平治疗原发性高血压的临床疗效及安全性

Clinical efficacy and safety of valsartan combining amlodipine in treatment of essential hypertension

目的 探讨原发性高血压患者服用缬沙坦联合氨氯地平的临床治疗效果与服药安全性。方法 选择2013年7月~2014年12月于西城区大栅栏社区卫生服务中心就诊的原发性高血压患者120例，男性66例，女性54例，年龄33~82岁。所有患者根据随机原则分为两组，观察组（60例）口服氨氯地平5 mg/d加缬沙坦80 mg/d；对照组（60例）口服氨氯地平5 mg/d，1/日，连续服用4个月。治疗前后测量血压并进行疗效评价。随访记录不良反应情况。结果 两组治疗4个月后收缩压和舒张压均较治疗前下降，差异有统计学意义（P均＜0.05）。与对照组治疗后比较，观察组收缩压和舒张压均下降，数值为[（137.1±16.7）mmHg vs. （126.7±12.3）mmHg]，[（93.5±10.5）mmHg vs. （80.4±9.8）mmHg]，差异有统计学意义（P均＜0.05）。两组患者治疗4个月后，观察组患者总有效率高于对照组（95% vs. 70%），差异具有统计学意义（P＜0.05）。两组患者的不良反应发生情况比较，差异无统计学意义（P＞0.05）。结论 缬沙坦联合氨氯地平治疗原发性高血压较单用氨氯地平可以更有效控制血压，不良反应少，安全性高，值得临床推广使用。

Objective To discuss the clinical efficacy and safety of valsartan combining amlodipine in patientswith essential hypertension. Methods The patients (n=120, male 66, female 54 and aged from 33 to 82) werechosen from Jul. 2013 to Dec. 2014. All patients were randomly divided into observation group (n=60) treated withamlodipine (5 mg/d) and valsartan (80 mg/d) and control group (n=60) treated with amlodipine (5 mg/d) once a dayfor 4 m. The changes of blood pressure (BP) were detected before and after treatment, curative effect was reviewed,and adverse reactions were recorded after follow-up. Results After treatment for 4 m, systolic blood pressure (SBP)and diastolic blood pressure (DBP) decreased in 2 groups (all P<0.05). SBP [(137.1±16.7) mmHg vs. (126.7±12.3)mmHg and DBP [(93.5±10.5) mmHg vs. (80.4±9.8) mmHg] decreased in observation group compared with controlgroup after treatment (all P<0.05). The total effective rate was higher in observation group than that in control group(95.0% vs. 70.0%) after treatment for 4 m (P<0.05). The difference in the incidence of adverse reactions had nostatistical significance between 2 groups (P>0.05). Conclusion Valsartan combining amlodipine can effectivelycontrol BP, reduce adverse reactions with higher safety in treatment of essential hypertension, which is well worthclinical application.