化痰祛湿降浊针药结合法治疗老年痰湿中阻型原发性高血压的临床观察

Clinical Value of Acupuncture Combined with Medication in Treatment of Essential Hypertension Due toPhlegm-Dampness Obstructionin the Elderly

目的 探究化痰祛湿降浊针药结合法在老年痰湿中阻型原发性高血压(Essential hypertension, EH)治疗中的应用价值。方法 选取2019年9月—2020年12月期间南京中医药大学针灸推拿学院收治的80例老年EH患者,采用随机数字余数法分为对照组与治疗组,每组各40例。对照组给予常规西药降压,治疗组在西药基础上给予中医针药结合(化痰祛湿降浊法)治疗,两组均治疗4周,治疗结束后随访1周。对比两组血压[收缩压(Systolic blood pressure, SBP)、舒张压(Diastolic blood pressure, DBP)]变化、中医证候疗效、高血压疗效、安全性、生活质量评分(CQQC)改善情况。结果 治疗1、4周后及随访1周后两组患者SBP、DBP水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组明显低于对照组,差异有统计学意义(P<0.05)。治疗后治疗组中医证候总有效率为90.0%(36/40)高于对照组62.5%(25/40),差异有统计学意义(P<0.05)。治疗后治疗组高血压治疗总有效率为100.0%(40/40)与对照组92.50%(37/40)比较,差异无统计学意义(P>0.05)。治疗期间,两组患者血尿常规、肝肾功能及心电图检查,均未见异常情况,不良反应发生率比较,差异无统计学意义(P>0.05)。治疗4周后、随访1周后两组患者CQQC评分均较治疗前高,差异有统计学意义(P<0.05);且治疗组明显高于对照组,差异有统计学意义(P<0.05)。结论 化痰祛湿降浊针药结合法治疗老年痰湿中阻型EH较单纯西药降压起效快,维持时间长,有利于改善患者生活质量,且安全性较高。

Objective To explorethe clinical value of acupuncture combined with medication in the treatment of essential hypertension(EH)due to phlegm-dampness obstruction in the elderly following the therapeutic principles of resolving phlegm, eliminating dampness, and descending turbidity.Methods Eighty elderly patients with EH admitted to School of Acupuncture and Tuina, Nanjing University of Chinese Medicine from September 2019 to December 2020 were randomly divided into a control group(40)and a treatment group(40)according to a random number table.The patients in the control group were treated by conventional western medicine to reduce blood pressure, while those in the treatment group receivedacupuncture combined with Chinese medicine treatment following the therapeutic principles of resolving phlegm, eliminating dampness, and descending turbidity on the basis of the therapeutic protocol of the control group.Both groups were treated for four weeks and followed up for one week after treatment.Blood pressurechanges[systolic blood pressure(SBP)and diastolic blood pressure(DBP)],traditional Chinese medicine(TCM)syndrome scores, efficacyon hypertension, safety, and Chinese Questionnaire on Quality of Life in Patients with Cardiovascular Disease(CQQC)scores were compared between the two groups.Results After oneand four weeks of treatment and one week of follow-up visit, SBP and DBP levels of the two groups were lower than those before treatment(P<0.05),and the treatment group was lower than the control group(P<0.05).In terms of the TCM syndrome score, the total effective rate of the treatment group was 90.0%(36/40),higher than 62.5%(25/40)in the control group(P<0.05).In terms of efficacy on hypertension, there was no significant difference in the total effective rate between the treatment group(100.0%,40/40)and the control group(92.50%,37/40)(P>0.05).During the treatment, no abnormalities in blood and urine routine examinations, liver andkidney functions, and electrocardiography were observed in the two groups, and there was no significant difference in the incidence of adverse events(P>0.05).The CQQC scores were higher in both groups after four weeks of treatment and one week of follow-up visit than those before treatment(P<0.05),the treatment group was higher than the control group(P<0.05).Conclusion Compared with the western medicine treatment alone, acupuncture combined with medication in the treatment of EH due to phlegm-dampness obstruction in the elderly following the therapeutic principles of resolving phlegm, eliminating dampness, and descending turbidityshows a faster onset of antihypertensive effect and longer action time, which is beneficial to the quality of life of patients with good safety.