养血清脑颗粒联合苯磺酸氨氯地平对老年高血压失眠病人血压变异性的影响

The Influence of Yangxue Qingnao Granule and Amlodipine Besylate on Blood Pressure Variability in Elderly Hypertensive Patients with Insomnia

目的探讨养血清脑颗粒联合苯磺酸氨氯地平对老年高血压失眠病人血压变异性的影响。方法将2014年10月—2015年8月在我院接受治疗的96例老年高血压失眠病人,按照随机数字表法分为观察组和对照组。对照组给予口服苯磺酸氨氯地平片治疗,观察组在对照组治疗的基础上给予养血清脑颗粒口服治疗,治疗2个疗程后观察两组临床疗效、24 h动态血压、血压变异性、血压晨峰、平均有效变异差异、中医证候积分和睡眠质量。结果治疗后观察组总有效率93.75%,高于对照组的77.08%,差异有统计学意义(χ~2=5.352,P=0.021)。治疗后观察组24 h动态血压、血压晨峰和平均有效变异均低于对照组,差异有统计学意义(P<0.05)。治疗后观察组血压变异性的24 h收缩压标准差(24 hSSD)、24 h舒张压标准差(24 hDSD)、白天收缩压标准差(dSSD)、白天舒张压标准差(dDSD)均低于对照组,差异有统计学意义(P<0.05),而夜间收缩压标准差(nSSD)和夜间舒张压标准差(nDSD)差异无统计学意义(P>0.05)。治疗后观察组眩晕、头疼、气短、乏力等证候积分均低于对照组,差异有统计学意义(P<0.05)。观察组主观睡眠质量、入睡时间、睡眠效率、催眠药物和睡眠质量总分低于对照组,差异有统计学意义(P<0.05)。结论在口服苯磺酸氨氯地平片治疗的基础上,养血清脑颗粒可提高临床疗效,改善老年高血压失眠病人的血压变异性和中医证候积分,提高睡眠质量。

Objective To investigate the effect of Yangxue Qingnao granule (YQG)and amlodipine besylate on blood pressure varia- bility (BPV)in elderly hypertensive patients with insomnia.Methods Ninetyty six elderly hypertensive patients with insomnia were randomly divided into two groups:control group (n = 48)treated with amlodipine besylate,and treatment group (n = 48)treated with amlodipine besylate plus YQG for 4 weeks.The clinical efficacy,24 h ambulatory blood pressure,BPV,blood pressure in the morning peak,scores of traditional Chinese medicine (TCM)symptom,and sleep quality were observed.Results The total clinical effective rate was 93.75% in treatment group,which was significantly higher than that in control group (77.08%,χ 2=5.352,P =0.021).The 24 h ambulatory blood pressure,blood pressure in the morning peak,average effective variation in treatment group were lower than that in control group after treatment (P <0.05).24hSSD,24 hDSD,dSSD,dDSD in treatment group were lower than that in con- trol group after treatment (P <0.05).The symptom scores of vertigo,headache,shortness of breath,fatigue in treatment group werelower than that in control group after treatment (P <0.05).The scores of subjective sleep quality,sleep time,sleep efficiency,hypnot- ic drug and sleep quality total score in treatment group were lower than that in control group after treatment (P <0.05).Conclusion YQG and amlodipine besylate can improve the clinical efficacy,BPV,TCM symptom scores,and sleep quality in elderly hypertensive patients with insomnia.