五苓散加减治疗钙离子拮抗剂所致踝部水肿56例

Analysis of 56 Cases of Ankle Edema caused by Calcium Antagonist Treated with Wuling Powder

目的:观察五苓散加减治疗钙离子拮抗剂(CCB)所致踝部水肿的临床效果,探索中西医结合防治高血压药物毒副作用的新方法。方法:将110例原发性高血压应用钙离子拮抗剂(CCB)后出现踝关节水肿的患者随机分为治疗组(56例)和对照组(54例)。其中治疗组在保持原有降压药物继续应用的同时,临证应用五苓散加减水煎服,1剂/d;对照组54例,继续应用原有降压药物不变,除此之外不再加用其他利水消肿药物,两组疗程均为2个月。分别观察并记录两组患者治疗前及治疗2个月后双侧踝关节外侧上方5cm处腿围的变化及患者血压的变化。结果:治疗组患者双踝外侧上方5cm处腿围治疗前平均值为28.2cm,治疗2月后平均值为23.5cm,治疗前后比较患者踝部水肿明显减轻,腿围明显缩小;治疗组患者血压治疗前平均值为141/91mmhg,治疗2月后平均值为130/82mmhg;两项观察指标治疗组均较观察组优异,相比差异具有统计学意义。结论:五苓散加减可明显改善钙离子拮抗剂(CCB)所致的踝部水肿,并对患者高血压的治疗也具有积极意义。

Objective: To observe the clinical effect of Wuling powder in the treatment of ankle edema caused by calcium ion antagonist(CCB), and to explore a new method of combined Chinese and western medicine for the prevention and treatment of adverse effects of hypertension drugs. Methods: 110 patients with ankle edema after calcium antagonist CCB were randomly divided into treatment group(56 cases) and control group(54 cases). In the treatment group, while maintaining the original anti-hypertensive drugs continued to use, the clinical application of Wuling powder plus water decoction, 1 dose a day;In the control group, 54 patients were treated with the same anti-hypertensive drugs as before, and no other anti-hypertensive drugs were added. The treatment course of both groups was 2 months. The changes of leg circumference and the changes of patients’ blood pressure at 5 cm above the lateral ankle joint of both sides before and 2 months after treatment were observed and recorded respectively in the two groups. Results: In the treatment group, the average value of the leg circumference at 5 cm above the lateral side of both ankles before treatment was 28.2 cm, and the average value after two months of treatment was 23.5 cm. The blood pressure of patients in the treatment group was 141/91 mmhg before treatment, and 130/82 mmhg two months after treatment. The two observation indexes were better in the treatment group than in the observation group, and the difference was statistically significant. Conclusion: Wuling powder can significantly improve ankle edema induced by calcium antagonist CCB, and has positive significance in the treatment of hypertension.