天麻钩藤饮加味治疗老年高血压阴虚阳亢证的临床效果及对脉压差的影响

Clinical effect of modified Tianma Gouteng decoction in the treatment of senile hypertension with Yin deficiency and Yang hyperactivity syndrome and its influence on pulse pressure difference

目的研究天麻钩藤饮加味治疗老年高血压阴虚阳亢证的临床效果及对脉压差的影响。方法选取西安大兴医院2020年3月至2020年10月门诊及住院的73例老年高血压阴虚阳亢证患者,根据随机数字表法将其分为对照组(37例)和观察组(36例)。对照组给予西医降压治疗,观察组在对照组基础上给予自拟天麻钩藤饮加味治疗。比较两组的临床疗效、中医证候疗效、收缩压、舒张压、脉压差、中医证候积分及不良反应发生情况。结果观察组的治疗总有效率高于对照组(P<0.05)。观察组的中医证候总有效率高于对照组(P<0.05)。治疗后,两组的收缩压、舒张压、脉压差均降低,且观察组的收缩压、脉压差均低于对照组(P<0.05)。治疗后,两组的中医证候各项积分均降低,且观察组低于对照组(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论天麻钩藤饮加味治疗老年高血压阴虚阳亢证的临床效果显著,可有效降低患者的血压、脉压差,缓解临床症状,改善预后,值得临床推广应用。

Objective To study the clinical effect of modified Tianma Gouteng decoction in the treatment of senile hypertension with Yin deficiency and Yang hyperactivity syndrome and its influence on pulse pressure difference.Methods Seventy-three elderly hypertension patients with Yin deficiency and Yang hyperactivity syndrome in the outpatient and inpatient department of Xi'an Daxing hospital from March 2020 to October 2020 were selected and divided into control group(37 cases)and observation group(36 cases)according to the random number table method.The control group was given antihypertensive treatment with western medicine,and the observation group was treated with self-made modified Tianma Gouteng decoction on the basis of the control group.The clinical efficacy,TCM syndrome efficacy,systolic blood pressure,diastolic blood pressure,pulse pressure difference,TCM syndrome score and adverse reactions were compared between the two groups.Results The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).The total effective rate of TCM syndrome in the observation group was higher than that in the control group(P<0.05).After treatment,the systolic blood pressure,diastolic blood pressure,pulse pressure difference in the two groups decreased,and the systolic blood pressure and pulse pressure difference in the observation group were lower than those in the control group(P<0.05).After treatment,the scores of TCM syndromes in the two groups decreased,and those in the observation group were lower than the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Modified Tianma Gouteng decoction in the treatment of senile hypertension with Yin deficiency and Yang hyperactivity syndrome has a significant clinical effect,it can effectively reduce the blood pressure and pulse pressure difference,alleviate clinical symptoms and improve prognosis,which is worthy of clinical promotion and application.