畲医活血消积方对H型高血压左室肥厚的临床疗效及内质网应激的影响

Effect of She Medicine Huoxue Xiaoji Recipe on clinical efficacy and endoplasmic reticulum stress in patients with H-type hypertension complicated left ventricular hypertrophy

目的观察畲医活血消积方对H型高血压左室肥厚血瘀证患者的临床疗效及内质网应激相关性标志物的影响,并探讨其作用机制。方法选择2018年4月—2019年5月就诊于丽水市中医院的H型高血压左室肥厚血瘀证患者80例,按照随机数字表法分为对照组和观察组,各40例。对照组采用西药治疗,观察组采用西药加畲医活血消积方治疗。比较2组患者降压疗效、中医证候积分、血压、同型半胱氨酸(Hcy)、左室肥厚指标及内质网应激相关性标志物的差异,同时记录不良反应。结果观察组降压总有效率为90.0%,高于对照组的72.5%(χ^(2)=4.021,P=0.045)。治疗后,观察组的中医证候积分、血压、Hcy、左室舒张末期内径和左心室质量指数均低于对照组(均P<0.05);观察组的血清葡萄糖调节蛋白78[(6.25±1.83)ng/mL]、蛋白激酶R样内质网激酶[(15.74±1.75)ng/mL]、C/EBP同源蛋白[(8.52±0.65)ng/mL]低于对照组[(7.35±1.07)ng/mL、(16.85±1.82)ng/mL、(9.45±0.58)ng/mL,t=3.282、2.780、6.751,均P<0.05]。2组均未见不良反应。结论畲医活血消积方治疗H型高血压左室肥厚血瘀证患者临床疗效显著,可能与该方有效调控内质网应激有关。

Objective To observe the effect of Sheyi Huoxue Xiaoji Recipe on clinical efficacy and endoplasmic reticulum stress-related markers in patients with H-type hypertension complicated left ventricular hypertrophy and blood stasis syndrome,and explore its mechanism of action.Methods A total of 80 patients with H-type hypertension complicated left ventricular hypertrophy and blood stasis syndrome in Lishui City Hospital of Traditional Chinese Medicine from April 2018 to May 2019 were selected and randomly divided into the control group and observation group according to the number table method(each with 40 cases).The control group was treated with Western medicine,whilst the observation group was treated with Western medicine plus Sheyi Huoxue Xiaoji Recipe.The changes of antihypertensive efficacy,TCM syndrome scores,blood pressure levels,homocysteine(Hcy),left ventricular hypertrophy indicators and endoplasmic reticulum stress-related markers were compared in both groups,and adverse reactions were recorded.Results The total effective rate of lowering blood pressure in the observation group was 90.0%,which was higher than 72.5%in the control group(χ^(2)=4.021,P=0.045).After treatment,the TCM syndrome score,blood pressure level,Hcy,left ventricular end-diastolic diameter and left ventricular mass index in the observation group were lower than those in the control group(all P<0.05).After treatment,the serum glucose-regulated protein 78[(6.25±1.83)ng/mL],protein kinase R-like ER kinase[(15.74±1.75)ng/mL]and C/EBP homologous protein[(8.52±0.65)ng/mL]were lower in the observation group than in the control group[(7.35±1.07)ng/mL,(16.85±1.82)ng/mL,(9.45±0.58)ng/mL,t=3.282,2.780,6.751,all P<0.05].No adverse reactions were observed in both groups.Conclusion The Sheyi Huoxue Xiaoji Recipe has a significant clinical effect in treating patients with H-type hypertension complicated left ventricular hypertrophy and blood stasis syndrome,which may be related to the effective regulation of endoplasmic reticulum stress.