加味温胆汤治疗老年高血压及对趋化因子CX3CL1影响的研究

Study on Jiawei Wendan Decoction in the treatment of senile hypertension and its influence on chemotactic factor CX3CL1

目的探索加味温胆汤治疗老年高血压及对血清趋化因子CX3CL1影响。方法选取2019年1月至2020年12月广州医科大学附属中医医院心血管内科收治的60例老年高血压患者作为研究对象,采用随机数字表法分为治疗组(30例)和对照组(30例)。所有患者入院后均服用苯磺酸氨氯地平片,治疗组在此基础上服用加味温胆汤,对照组服用中药安慰剂。比较两组临床疗效、治疗前后中医证候积分、动态血压指标、室间隔厚度(IVS)及颈动脉内膜中层厚度(IMT)、血清趋化因子CX3CL1水平及不良心血管事件发生率。结果治疗组的治疗总有效率为高于对照组,差异有统计学意义(P<0.05)。治疗组治疗后的中医证候积分低于对照组,差异有统计学意义(P<0.05)。两组治疗前24 h的平均SBP、24 h平均DBP、IVS、IMT及CX3CL1水平比较,差异无统计学意义(P>0.05);两组治疗后24 h的平均SBP、24 h平均DBP、IVS、IMT及CX3CL1水平均低于治疗前,且治疗组治疗后24 h的平均SBP、24 h的平均DBP、IVS、IMT及CX3CL1均低于对照组,差异有统计学意义(P<0.05)。结论加味温胆汤在老年高血压患者治疗中效果明显,能够有效改善各种临床症状,降低血压水平,具有促进血管内皮功能保护作用,安全性高,值得推广。

Objective To explore the treatment of senile hypertension with Jiawei Wendan Decoction and its influence on serum chemokine CX3CL1.Methods A total of 60 senile hypertensive patients admitted to Department of Cardiovascular Medicine,Affiliated Hospital of Traditional Chinese Medicine,Guangzhou Medical University from January 2019 to December 2020 were selected as the research objects,and were divided into treatment group(30 cases)and control group(30 cases)using the random number table method.All patients took Amlodipine Besylate Tablets after admission,the treatment group took Jiawei Wendan Decoction on this basis,and the control group took traditional Chinese medicine(TCM)placebo.The clinical efficacy,TCM syndrome scores before and after treatment,ambulatory blood pressure indicators,interventricular septal thickness(IVS)and carotid artery intima-media thickness(IMT),serum chemokine CX3CL1 levels and incidence of adverse cardiovascular events were compared between the two groups.Results The total effective rate of treatment in the treatment group was higher than that in the control group,and the difference was statistically significant(P<0.05).The TCM syndrome scores of the treatment group after treatment were lower than those in the control group,and the difference was statistically significant(P<0.05).There were no significant differences in the 24 h average SBP and the 24 h average DBP,IVS,IMT and CX3CL1 between the two groups before treatment(P>0.05);after treatment,24 h average SBP,24 h average DBP,IVS,IMT and CX3CL1 levels of the two groups were lower than before treatment,and 24 h average SBP,24 h average DBP,IVS,IMT and CX3CL1 after treatment in the treatment group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion Jiawei Wendan Decoction has obvious effects in the treatment of senile hypertensive patients.It can effectively improve various clinical symptoms,reduce blood pressure,and has a protective effect on promoting vascular endothelial function.It has high safety and is worthy of promotion.