珍菊降压片联合硝苯地平缓释片治疗原发性高血压疗效观察及对血管内皮功能、胱抑素C、同型半胱氨酸和超敏C反应蛋白水平的影响

Effect of Zhenju hypotensive tablet combined with nifedipine sustained release tablet on essential hypertension and its influence on vascular endothelial function,expression of CysC,Hcy and hs-CRP

目的:探讨珍菊降压片联合硝苯地平缓释片治疗原发性高血压疗效观察及对患者血管内皮功能、胱抑素C(CysC)、同型半胱氨酸(Hcy)和超敏C反应蛋白(hs-CRP)水平的影响。方法:选择诸暨市中医医院于2018年9月至2019年9月收治的原发性高血压患者182例为观察对象,采用随机数字表法分为观察组(91例)与对照组(91例)。对照组患者口服硝苯地平缓释片,观察组患者在对照组基础上口服珍菊降压片。两组疗程均为12周。比较两组治疗疗效,治疗前后血压、血管内皮功能、CysC、Hcy和hs-CRP水平变化以及不良反应发生情况。结果:观察组总有效率[91.21%(83/91)]高于对照组[79.12%(72/91)](χ2=5.262,P<0.05);两组治疗12周收缩压(SBP)和舒张压(DBP)较治疗前降低(t观察组=29.054、26.702,t对照组=27.449、20.145,均P<0.05);观察组治疗12周SBP和DBP低于对照组(t=12.704、8.177,均P<0.05)。两组治疗12周血浆内皮素1(ET-1)水平较治疗前降低而一氧化氮(NO)水平较治疗前升高(t观察组=27.388、18.644,t对照组=9.480、9.657,均P<0.05);观察组治疗12周血浆ET-1水平低于对照组而NO水平高于对照组(t=22.384、9.134,均P<0.05);两组治疗12周血清CysC、Hcy和hs-CRP水平较治疗前降低(t观察组=31.586、23.159、29.776,t对照组=11.641、13.649、16.521,P<0.05);观察组治疗12周血清CysC、Hcy和hs-CRP水平均低于对照组(t=17.193、10.554、14.671,均P<0.05);观察组不良反应发生率低于对照组(χ2=7.959,P<0.05)。结论:珍菊降压片联合硝苯地平缓释片治疗原发性高血压效果良好,可改善患者血管内皮功能,降低CysC、Hcy和hs-CRP表达,且不良反应少。

Objective To investigate the therapeutic effect of Zhenju hypotensive tablet combined with nifedipine sustained-release tablet in the treatment of essential hypertension,and its influence on the vascular endothelial function,expression of cystatin C(CysC),homocysteine(Hcy)and hypersensitive C-reactive protein(hs-CRP).Methods From September 2018 to September 2019,182 patients with essential hypertension were enrolled in Zhuji Hospital of Traditional Chinese Medicine.They were divided into observation group(91 cases)and control group(91 cases)according to the random digital table method.The control group was given nifedipine sustained-release tablets,while the observation group received Zhenju hypotensive tablets on the basis of the control group.The course of treatment in both two groups was 12 weeks.After treatment,the changes of blood pressure,endothelial function,CysC,Hcy and hs-CRP levels and adverse reactions were compared.Results The total effective rate of the observation group(91.21%)was higher than that of the control group(79.12%)(χ2=5.262,P<0.05).The SBP and DBP in the two groups were decreased after treatment for 12 weeks(tobservation group=29.054,26.702,tcontrol grouP=27.449,20.145,all P<0.05).The SBP and DBP in the observation group were lower than those in the control group(t=12.704,8.177,all P<0.05).After treatment for 12 weeks,the plasma level of ET-1 in the two groups were lower than those before treatment,and the level of NO the two groups were higher than those before treatment(tobservation group=27.388,18.644,tcontrol group=9.480,9.657,all P<0.05).The plasma level of ET-1 in the observation group was lower than that in the control group,and the level of NO in the observation group was higher than that in the control group,the differences were statistically significant(t=22.384,9.134,all P<0.05).The levels of CysC,Hcy and hs-CRP in the two groups after treatment for 12 weeks were lower than those before treatment(tobservation group=31.586,23.159,29.776,tcontrol grouP=11.641,13.649,16.521,all P<0.05).The levels of CysC,Hcy and hs-CRP in the observation group were lower than those in the control group(t=17.193,10.554,14.671,all P<0.05).The adverse reaction in the observation group was less than those in the control group(χ2=7.959,P<0.05).Conclusion Zhenju hypotensive tablet combined with nifedipine sustained-release tablet has good therapeutic effect in the treatment of essential hypertension.It can improve the vascular endothelial function,reduce the expression of CysC,Hcy and hs-CRP,and has fewer adverse reactions.