半夏白术天麻汤化裁治疗痰湿壅盛证原发性高血压的临床效果

Clinical effect of Banxia Baizhu Tianma Decoction flexible modification in the treatment of essential hypertension with phlegm-dampness syndrome

目的探讨半夏白术天麻汤化裁治疗痰湿壅盛证原发性高血压的临床效果。方法选取2019年6月至2021年3月黑龙江省中医药科学院心内科收治的90例痰湿壅盛证原发性高血压患者作为研究对象,采用随机数字表法将其分为对照组和治疗组,每组各45例。对照组患者予以口服硝苯地平控释片治疗,治疗组患者在对照组的基础上予以半夏白术天麻汤化裁治疗。治疗8周后,比较两组患者的中医证候积分、中医疗效、收缩压、舒张压、血清一氧化氮(NO)、内皮素-1(ET-1)水平变化及不良反应发生情况。结果治疗后,治疗组患者的总有效率为86.67%,高于对照组的75.56%,差异有统计学意义(P<0.05)。两组患者治疗后的中医证候评分低于治疗前,且治疗组患者治疗后的中医证候评分低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者的收缩压、舒张压水平均低于治疗前,且治疗组患者治疗后的收缩压、舒张压水平均低于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者的NO水平高于治疗前,ET-1水平低于治疗前,且治疗组患者治疗后的NO水平高于对照组,ET-1水平低于对照组,差异有统计学意义(P<0.05)。在治疗过程中,未出现明显的不良反应。结论对痰湿壅盛证原发性高血压患者予半夏白术天麻汤化裁治疗,可提高降压效果,改善头痛、头晕等中医临床症状,改善血管内皮功能,且安全有效,值得临床推广。

Objective To explore the clinical effect of Banxia Baizhu Tianma Decoction flexible modification in the treatment of essential hypertension with phlegm-dampness syndrome.Methods Ninety patients with essential hypertension diagnosed as phlegm-dampness syndrome treated in the Department of Cardiology Heilongjiang Academy of Chinese Medicine Sciences from June 2019 to March 2021 were selected as the research subjects,and they were divided into the treatment group and the control group by the random number table method,45 cases in each group.The patients in the control group were treated with oral Nifedipine Controlled-release Tablets,and in the treatment group,they were treated with Banxia Baizhu Tianma Decoction flexible modification on the basis of the control group.After 8 weeks of treatment,traditional Chinese medicine(TCM)syndrome score,TCM efficacy,systolic blood pressure,diastolic blood pressure,serum nitric oxide(NO),endothelin-1(ET-1)levels and incidence of adverse reactions were compared between the two groups.Results After treatment,the total effectiveness rate of the treatment group was 86.67%,which was higher than that in the control group accounting for 75.56%,the difference was statistically significant(P<0.05).The TCM syndrome scores of patients in the two groups after treatment were lower than those before treatment,and the TCM syndrome scores of patients in the treatment group were lower than those in the control group after treatment,and the differences were statistically significant(P<0.05).After treatment,the systolic and diastolic blood pressure levels of patients in the two groups were lower than those before treatment,and the systolic and diastolic blood pressure levels of the patients in the treatment group after treatment were lower than those in the control group,the differences were statistically significant(P<0.05).After treatment,the NO levels of patients in the two groups were higher than those before treatment,and the ET-1 levels of patients in the two groups were lower than those before treatment,the NO level of the treatment group after treatment was higher than that in the control group,and the ET-1 level of the treatment group after treatment was lower than that in the control group,the differences were statistically significant(P<0.05).During the treatment,no obvious adverse reactions occurred.Conclusion For patients with essential hypertension identified as phlegm-dampness syndrome,Banxia Baizhu Tianma Decoction flexible modification can improve blood pressure lowering,headache,dizziness and other TCM clinical symptoms,as well as vascular endothelial function.It is safe and effective,and is worthy of clinical promotion.