阿利沙坦酯联合硝苯地平缓释片对中重度原发性高血压伴心绞痛疗效和安全性的研究

Study on the efficacy and safety of allisartan isoproxil combined with nifedipine sustained-release tablets in the treatment of moderate to severe primary hypertension with angina pectoris

目的观察阿利沙坦酯联合硝苯地平缓释片对中重度原发性高血压伴心绞痛疗效和安全性。方法选取2021年1月至2022年1月佛山市中医院禅城高新区医院老年医学科收治的符合纳入标准的120例中重度原发性高血压伴心绞痛患者,根据随机数表法分为研究组和对照组,每组各60例。对照组使用硝苯地平缓释片Ⅰ治疗,研究组在对照组基础上联合阿利沙坦酯片治疗,疗程为12周。治疗前后测量诊室血压并进行动态血压监测,评估降压效果,计算血压达标率。记录治疗期间两组心绞痛发作持续时间、发作频率、硝酸甘油用量,评估心绞痛改善情况。测量治疗前后患者生命体征,并行血尿常规、血糖、胆固醇、三酰甘油、尿素氮、肌酐、尿酸、血电解质、转氨酶、血清肌酐等实验室检查,记录治疗期间不良反应发生情况。结果治疗后,两组诊室收缩压(SBP)和舒张压(DBP)均较治疗前降低,且研究组低于对照组(P<0.05)。治疗后,两组24 h SBP、24 h DBP、白昼SBP(dSBP)、白昼DBP(dDBP)、夜间SBP(nSBP)和夜间DBP(nDBP)均降低,且研究组低于对照组(P<0.05)。研究组降压总有效率高于对照组(P<0.05)。两组与同组治疗2周后和治疗4周后比较,治疗8周后和治疗12周后两组血压达标率均增加(P<0.05)。治疗后,两组心绞痛发作持续时间、发作频率、硝酸甘油用量均较治疗前减少,且研究组低于对照组(P<0.05)。研究组心绞痛改善总有效率高于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论阿利沙坦酯联合硝苯地平缓释片治疗中重度原发性高血压伴心绞痛疗效显著,有效降压并维持血压稳定的同时,还可改善心绞痛症状,且安全性较高,具有临床应用价值。

Objective To observe the efficacy and safety of allisartan isoproxil combined with nifedipine sustainedrelease tablets in the treatment of moderate to severe primary hypertension with angina pectoris.Methods A total of 120 patients with moderate to severe primary hypertension and angina pectoris admitted to the Department of Geriatrics of Chancheng High-tech Zone Hospital of Foshan Hospital of Traditional Chinese Medicine from January 2021 to January 2022,who met the inclusion and exclusion criteria,were included in the study.They were divided into a study group and a control group using a random number table method,with 60 patients in each group.The control group was treated with nifedipine sustained-release tablets I,while the study group was additionally treated with allisartan isoproxil tablets based on the treatment of the control group,with a course of 12 weeks.The blood pressure in the consultation room before and after treatment was measured,dynamic blood pressure monitoring was conducted to assess the effect of blood pressure reduction,and the blood pressure compliance rate was calculated.The duration and frequency of angina pectoris,and dosage of nitroglycerin during the treatment period in both groups were recorded,and the improvement of angina pectoris was assessed.The patient’s vital signs before and after treatment were measured,and laboratory tests such as blood and urine routine,blood glucose,cholesterol,triglycerides,urea nitrogen,creatinine,uric acid,blood electrolytes,transaminases,and serum creatinine were conducted.The occurrence of adverse reactions during treatment was recorded.Results After treatment,the systolic blood pressure(SBP)and diastolic blood pressure(DBP)in both groups decreased compared to those before treatment,and the values in the study group were lower than those in the control group(P<0.05).After treatment,the 24-hour SBP,24-hour DBP,daytime systolic blood pressure(dSBP),daytime diastolic blood pressure(dDBP),nighttime systolic blood pressure(nSBP),and nighttime diastolic blood pressure(nDBP)in both groups decreased,and the values in the study group were lower than those in the control group(P<0.05).The total effective rate of blood pressure reduction in the study group was higher than that in the control group(P<0.05).Compared with that after 2 weeks and 4 weeks of treatment,the blood pressure compliance rate increased in both groups after 8 weeks and 12 weeks of treatment(P<0.05).After treatment,the duration,frequency,and dosage of nitroglycerin for angina attacks in both groups decreased compared to those before treatment,and those were lower in the study group than in the control group(P<0.05).The total effective rate of improving angina pectoris in the study group was higher than that in the control group(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Allisartan isoproxil combined with nifedipine sustained-release tablets has a significant therapeutic effect on moderate to severe primary hypertension with angina pectoris.It effectively reduces blood pressure and maintains blood pressure stability,while also improving symptoms of angina pectoris,with high safety and clinical application value.