丹参酮ⅡA磺酸钠注射液联合卡托普利片治疗原发性高血压临床观察

Clinical observation of tanshinone ⅡA sodium sulfonate injection combined with captopril tablets in the treatment of essential hypertension

目的观察丹参酮ⅡA磺酸钠注射液联合卡托普利片治疗原发性高血压的临床疗效。方法将114例原发性高血压患者按照随机数字表法分为2组。对照组57例予卡托普利片治疗;治疗组57例在对照组治疗基础上加丹参酮ⅡA磺酸钠注射液治疗。2组均治疗1个月。比较2组中医证候疗效;观察2组治疗前后血压变化;观察2组治疗前后胰岛素抵抗指数(HOMA-IR)、颈动脉内膜中层厚度(IMT)水平变化;比较2组治疗前后血脂指标甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平变化;检测2组治疗前后内皮损伤标志因子氧化低密度脂蛋白(Ox-LDL)、血管性假血友病因子(vWF)、血管内皮生长因子(VEGF)水平。结果治疗组总有效率92. 98%,对照组总有效率75. 44%,治疗组中医证候疗效优于对照组(P <0. 05)。2组治疗后血压水平均较本组治疗前降低(P <0. 05),且治疗组降低更明显(P <0. 05)。2组治疗后HOMA-IR、IMT水平均较本组治疗前降低(P <0. 05),且治疗组降低更明显(P <0. 05)。2组治疗后TG、TC及LDL-C水平均较本组治疗前降低(P <0. 05),且治疗组降低更明显(P <0. 05)。2组治疗后OxLDL、vWF及VEGF水平均较本组治疗前降低(P <0. 05),且治疗组降低更明显(P <0. 05)。结论丹参酮ⅡA磺酸钠注射液联合卡托普利片治疗原发性高血压,能改善患者IR,控制血压,调节血脂,可能与血清OxLDL、vWF、VEGF水平降低有关。

Objective To observe the clinical effects of tanshinone IIA sodium sulfonate injection combined with captopril tablets in the treatment of essential hypertension.Methods 114 patients with essential hypertension were divided into two groups according to the random number table method.57 cases in control group were treated by captopril tablets.57 cases in treatment group were treated by sodium tanshinone IIA sulfonate injection on the basis of the control group.Both groups were treated for one month.The curative effect of two groups of TCM were compared.The changes of blood pressure before and after treatment in two groups were observed.The changes of insulin resistance index (HOMA-IR) and carotid intima-media thickness (IMT) were observed between the two groups before and after treatment.The levels of triglyceride (TG),total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) were compared between the two groups before and after treatment.The levels of oxidized low density lipoprotein (Ox-LDL),von Willebrand factor (vWF) and vascular endothelial growth factor (VEGF) in two groups were measured before and after treatment.Results The total effective rate was 92.98% in treatment group and 75.44% in control group.The curative effect of TCM syndromes in the treatment group was better than that in the control group (P<0.05).After treatment,the blood pressure levels of the two groups were lower than those in the group before treatment (P<0.05),and the treatment group decreased more significantly (P<0.05).After treatment,the levels of HOMA-IR and IMT of the two groups were lower than those in the group before treatment (P<0.05),and the treatment group decreased more significantly (P<0.05).After treatment,the levels of TG,TC and LDL-C of the two groups were lower than those in the group before treatment (P<0.05),and the treatment group decreased more significantly (P<0.05).After treatment,the levels of Ox-LDL,vWF and VEGF of the two groups were lower than those in the group before treatment (P<0.05 ),and the treatment group decreased more significantly (P<0.05).Conclusion Tanshinone IIA sodium sulfonate injection combined with captopril tablets can improve IMT and IR,control blood pressure and regulate blood lipids in patients with essential hypertension,which may be related to the decrease of serum Ox-LDL,vWF and VEGF levels.