氨氯地平阿托伐他汀钙片联合血府逐瘀软胶囊治疗原发性高血压合并颈动脉粥样硬化患者的疗效观察

Efficacy of Amlodipine and Atorvastatin Calcium Tablets Combined with Xuefu Zhuyu Soft Capsule in the Treatment of Patients with Primary Hypertension and Carotid Atherosclerosis

目的观察应用氨氯地平阿托伐他汀钙片联合血府逐瘀软胶囊治疗原发性高血压合并颈动脉粥样硬化患者的疗效。方法选取2018年8月—2020年2月期间于福建医科大学附属宁德市医院就诊的212例原发性高血压合并颈动脉粥样硬化患者为研究对象,按随机数字表法分为两组,每组106例。治疗组以氨氯地平阿托伐他汀钙片联合血府逐瘀软胶囊治疗,对照组以氨氯地平阿托伐他汀钙片治疗,两组均治疗6个月。统计分析治疗前后两组患者血清超敏C反应蛋白(high sensitivity C-reactive protein,hs-CPR)、胱抑素C(Cystatin C,CysC)、血管内皮素-1(Endothelin-1,ET-1)、颈动脉斑块变化情况,并观察两组患者治疗后的临床疗效、临床症状评分及不良反应。结果治疗6个月后,治疗组总有效率96.23%(102/106),对照组总有效率87.74%(93/106),两组比较差异有统计学意义(P<0.05)。治疗6个月后两组患者临床症状评分均较治疗前下降(P<0.05),且治疗组临床症状评分均低于对照组,两组比较差异有统计学意义(P<0.05)。两组患者治疗6个月后hs-CRP、Cys-C及ET-1水平均较治疗前下降(P<0.05),且治疗组hs-CRP、Cys-C及ET-1水平均低于对照组,两组比较差异有统计学意义(P<0.05)。两组患者治疗6个月后颈动脉狭窄度、斑块厚度、斑块面积、IMT及Crouse斑块积分均较治疗前下降(P<0.05),且治疗组颈动脉狭窄度、斑块厚度、斑块面积、IMT及Crouse斑块积分均低于对照组,两组比较差异有统计学意义(P<0.05)。在治疗过程中,两组患者均无明显不良反应发生。结论氨氯地平阿托伐他汀钙片联合血府逐瘀软胶囊治疗原发性高血压合并颈动脉粥样硬化患者疗效确切,可有效改善临床症状,明显降低炎症反应及IMT,安全性高,值得临床推广使用。

Objective To observe the effect of applying amlodipine and atorvastatin calcium tablets combined with Xuefu Zhuyu soft capsule in the treatment of patients with essential hypertension and carotid atherosclerosis.Methods A total of 212 patients with essential hypertension and hyperlipidemia who were treated at Ningde Hospital Affiliated to Fujian Medical University from August 2018 to February 2020 were selected as the study subjects.They were divided into treatment group(106 cases,amlodipine atorvastatin calcium tablets combined with Xuefu Zhuyu soft capsule)and control group(106 cases,amlodipine atorvastatin calcium tablets)by random number table method.The changes of serum high sensitivity-C-reactive protein(HS-CPR),Cystatin C(CYS-C),endothelin-1(ET-1)and carotid artery plaque in the two groups before and after treatment were statistically analyzed,and the clinical efficacy,clinical symptom scores and adverse reactions of the two groups after treatment were observed.Results After 6 months of treatment,the total effective rate in the treatment group was 96.23%(102/106),and the total effective rate in the control group was 87.74%(93/106).The difference between the two groups was statistically significant(P<0.05).After 6 months of treatment,the clinical symptom scores of the two groups were lower than before treatment(P<0.05),and the clinical symptom scores of the treatment group were lower than those of the control group.The difference between the two groups was statistically significant(P<0.05).After 6 months of treatment,the levels of hs-CRP,Cys-C and ET-1 in the two groups were lower than before treatment(P<0.05),and the levels of hs-CRP,Cys-C and ET-1 in the treatment group were lower than those of the control Group,the difference between the two groups was statistically significant(P<0.05).After 6 months of treatment,the carotid artery stenosis,plaque thickness,plaque area,IMT and Crouse plaque scores of the two groups decreased compared with those before treatment(P<0.05),and the carotid artery stenosis,plaque thickness,The plaque area,IMT and Crouse plaque scores were lower than those of the control group,and the difference between the two groups was statistically significant(P<0.05).During the treatment,no adverse reactions occurred in the two groups of patients.Conclusion Amlodipine and atorvastatin calcium tablets combined with Xuefu Zhuyu Soft Capsule are effective in treating patients with primary hypertension complicated with carotid atherosclerosis,which can effectively improve clinical symptoms,significantly reduce inflammation and IMT,and have high safety.It is worthy of clinical application.