加味二仙汤治疗围绝经期高血压冲任失调证的疗效及对患者神经递质和性激素的影响

Curative effect of modified Erxian Decoction in treating perimenopausal hypertension with Chong Ren disorder syndrome and its influence on neurotransmitters and sex hormones

目的观察加味二仙汤治疗围绝经期高血压冲任失调症的疗效,并探讨其对患者神经递质和性激素的影响。方法选择2019年2月至2020年1月佛山市中医院三水医院收治的80例围绝经期高血压冲任失调症患者作为研究对象。采用随机数表法分观察组和对照组,每组40例。两组患者均接受尼群地平口服治疗,对照组同时给予贝那普利治疗,观察组在对照组治疗基础上联合加味二仙汤治疗。治疗8周后,比较两组患者的治疗效果,以及治疗前后的血压、任失调证评分、Kupperman评分、神经递质[血浆神经肽Y(NPY)、神经降压素(NT)]及性激素[血清雌二醇(E2)、睾酮(T)、孕酮(P)、性激素结合蛋白(SHGB)]水平,同时比较两组患者治疗期间的不良反应情况。结果观察组患者的治疗总有效率为95.0%,明显高于对照组的80.0%,差异有统计学意义(P<0.05);治疗后,两组患者的舒张压(DBP)、收缩压(SBP)均下降,且观察组[(113.32±9.11)mmHg、(71.12±6.11)mmHg]明显低于对照组[(125.13±10.33)mmHg、(76.29±5.61)mmHg],差异均有统计学意义(P<0.05);治疗后,两组患者的冲任失调证评分、Kupperman评分均降低,且观察组[(9.13±2.11)分、(6.78±1.01)分]明显低于对照组[(15.12±3.02)分、(10.13±2.21)分],差异均有统计学意义(P<0.05);治疗后,两组患者的NPY、NT均降低,且观察组[(96.13±7.13)ng/L、(51.17±8.14)ng/L]明显低于对照组[(105.18±8.02)ng/L、(62.36±7.11)ng/L],差异均有统计学意义(P<0.05);治疗后,两组患者的P、T水平均降低,且观察组[(3.99±0.79)pmol/L、(1.67±0.31)nmol/L]明显低于对照组[(4.62±1.02)pmol/L、(2.68±0.52)nmol/L],E2、SHGB水平均升高,且观察组[(65.13±7.11)pmol/L、(48.46±5.11)nmol/L]明显高于对照组[(54.89±6.22)pmol/L、(42.12±6.23)nmol/L],差异均有统计学意义(P<0.05)。结论加味二仙汤治疗围绝经期高血压冲任失调证能有效改善患者的临床症状,调节神经递质和性激素水平,临床治疗效果较好。

Objective To observe the curative effect of modified Erxian Decoction in the treatment of perimenopausal hypertension with Chong Ren disorder, and to explore its influence on neurotransmitters and sex hormones.Methods Eighty patients of perimenopausal hypertension with Chong Ren disorder in Sanshui Hospital of Foshan Traditional Chinese Medicine from February 2019 to January 2020 were selected as the research objects. They were randomly divided into an observation group and a control group, with 40 patients in each group. Plus nitrendipine oral treatment,patients in the control group was given benazepril treatment, and patients in the observation group were treated with modified Erxian Decoction on the basis of the control group. After 8 weeks of treatment, the treatment effect, blood pressure, Ren maladjustment syndrome score, Kupperman score, neurotransmitter(plasma neuropeptide Y [NPY], neurotensin [NT]), and sex hormone(serum estradiol [E2], testosterone [T], progesterone [P], sex hormone binding protein[SHGB]) levels before and after treatment were compared between the two groups, and the adverse reactions during treatment were compared between the two groups situation. Results The total effective rate of the observation group(95.0%) was significantly higher than that of the control group(80.0%), and the difference was statistically significant(P<0.05). After treatment, the diastolic blood pressure(SBP) and systolic blood pressure(DBP) of the two groups of patients decreased, and the levels in the observation group were(113.32±9.11) mmHg, 71.12±6.11) mmHg, significantly lower than(125.13 ± 10.33) mmHg,(76.29 ± 5.61) mmHg in the control group(P<0.05);after treatment, the scores of Chong Ren disorder syndrome and Kupperman scores of the two groups decreased, and the scores in the observation group were(9.13±2.11) points,(6.78±1.01) points, significantly lower than(15.12±3.02) points,(10.13±2.21) points in the control group(P<0.05);after treatment, NPY and NT of the two groups were decreased, and the levels in the observation group were(96.13±7.13) ng/L,(51.17 ± 8.14) ng/L, significantly lower than(105.18±8.02) ng/L,(62.36±7.11) ng/L in the control group(P<0.05);after treatment, P and T in two groups are decreased, and the levels in the observation group were(3.99±0.79) pmol/L,(1.67±0.31) nmol/L, significantly lower than(4.62±1.02) pmol/L,(2.68±0.52) nmol/L of the control group;E2, SHGB were increased after treatment, and the levels in the observation group were(65.13 ±7.11) pmol/L,(48.46±5.11) nmol/L, significantly higher than(54.89±6.22) pmol/L,(42.12±6.23) nmol/L in the control Group. Conclusion Modified Erxian Decoction can effectively improve the clinical symptoms of patients with perimenopausal hypertension and Chong Ren disorder, regulate neurotransmitter and sex hormone levels, with better clinical treatment effect.