温胆汤合平肝潜阳汤对原发性高血压病痰湿壅盛证疗效及血脂代谢的影响

Effect of Wendan Decoction(温胆汤)and Pinggan Qianyang Decoction(平肝潜阳汤)on Primary Hypertension with Phlegm-Dampness Syndrome and Blood Lipid Metabolism

目的探讨温胆汤合平肝潜阳汤对原发性高血压病痰湿壅盛证的疗效及血脂代谢的影响。方法选择2019年2月—2021年7月医院收治的108例原发性高血压病湿壅盛证患者为研究对象,以随机数字表法将其分为研究组(54例)与对照组(54例)。对照组在常规治疗基础上接受硝苯地平缓释片治疗,研究组在对照组的基础上接受温胆汤合平肝潜阳汤治疗。两组均持续治疗2个疗程后观察效果。对比两组治疗前后中医证候积分、血压水平[24 h平均舒张压(diastolic blood pressure,DBP)、24 h平均收缩压(systolic blood pressure,SBP),DBP变异性(diastolic blood pressure variability,DBPV)、SBP变异性(systolic blood pressure variability,SBPV)]、血脂代谢水平[甘油三酯(triglycerides,TG)、低密度脂蛋白(low density lipoprotein,LDL-C)、总胆固醇(TC)及高密度脂蛋白(high density lipoprotein,HDL-C)]、内皮损伤标志物[细胞间黏附分子-1(intercellular adhesion molecule-1,ICAM-1)、内皮素-1(endothelin-1,ET-1)],对比两组临床疗效及不良反应发生情况。结果治疗后,两组头痛、眩晕、头如裹、心悸、口淡、失眠等各项中医证候积分均降低(P<0.05),且研究组更低(P<0.05);研究组总有效率(92.59%,50/54)比对照组(77.78%,42/54)高(P<0.05);治疗后,两组DBPV、SBPV、24 h平均DBP及24 h平均SBP水平均降低(P<0.05),且研究组更低(P<0.05);治疗后,两组TG、LDL-C、TC水平均降低(P<0.05),且研究组更低(P<0.05);治疗后,两组HDL-C水平均升高(P<0.05),且研究组更高(P<0.05);治疗后,两组血清ICAM-1、ET-1水平均降低(P<0.05),且研究组更低(P<0.05);两组总不良反应发生率对比差异无统计学意义(P>0.05)。结论温胆汤合平肝潜阳汤联合硝苯地平治疗原发性高血压病痰湿壅盛证效果显著,可改善患者临床症状、血压水平、血脂代谢水平,可减轻内皮损伤,且安全可靠。

Objective To investigate the curative effect of(温胆汤)and Pinggan Qianyang Decoction(平肝潜阳汤)on primary hypertension with phlegm-dampness syndrome and the effect on blood lipid metabolism.Methods From February 2019 to July 2021,108 patients with primary hypertension and phlegm-dampness syndrome were selected as the research objects,and they were divided into the study group(54 cases)and the control group(54 cases)by random number table method.The control group received Nifedipine Sustained-Release Tablets on the basis of routine treatment,and the study group received Wendan Decoction and Pinggan Qianyang Decoction on the basis of the control group.The TCM symptom scores,blood pressure levels[24-hour mean diastolic blood pressure(DBP),24-hour mean systolic blood pressure(SBP),DBP variability(DBPV),SBP variability(SBPV)],blood lipid metabolism level[triglycerides(TG),low density lipoprotein(LDL-C),total cholesterol(TC)and high density lipoprotein(HDL-C)],endothelial injury markers[intercellular adhesion molecule-1(ICAM-1),endothelial Element-1(ET-1)]were compared between the two groups before and after treatment.The clinical efficacy and adverse reactions were compared between the two groups.Results After treatment,the scores of TCM symptoms such as headache,dizziness,dizziness,palpitations,light mouth and insomnia in the two groups were decreased(P<0.05)and the scores of the study group were lower(P<0.05).The total effective rate of the study group(92.59%,50/54)was higher than that of the control group(77.78%,42/54)(P<0.05).After treatment,the levels of DBPV,SBPV,24-hour average DBP and 24-hour average SBP in the two groups were decreased(P<0.05)and those were lower in the study group(P<0.05).After treatment,the levels of TG,LDL-C and TC in the two groups were decreased(P<0.05),and the levels in the study group were lower(P<0.05).After treatment,the levels of HDL-C in both groups were increased(P<0.05)and the level in the study group was higher(P<0.05).After treatment,the levels of serum ICAM-1 and ET-1 in both groups were decreased(P<0.05),and those in the study group were lower(P<0.05).There was no significant difference in the incidence of total adverse reactions between the two groups(P>0.05).Conclusion Wendan Decoction and Pinggan Qianyang Decoction combined with nifedipine has a significant effect in the treatment of primary hypertension with phlegm-dampness syndrome.It can improve the clinical symptoms,blood pressure level and blood lipid metabolism level of patients and reduce the endothelial damage,and it is safe and reliable.