生脉饮合五苓散加味治疗老年高血压患者体位性低血压的临床效果

Clinical effect of modified Shengmai Yin combined with Wuling powder in the treatment of orthostatic hypotension in elderly patients with hypertension

目的 探讨生脉饮合五苓散加味治疗老年高血压患者体位性低血压的临床效果。方法 将265例老年高血压合并体位性低血压患者按随机数字表法分为对照组(133例)和观察组(132例)。对照组给予内科常规治疗,观察组在对照组基础上服用生脉饮合五苓散加味水煎剂。比较两组的治疗效果。结果 观察组的综合治疗总有效率高于对照组(P<0.01)。治疗后,观察组的卧位收缩压(SBP)、立位SBP、脉压指数(PPI)低于对照组,卧位舒张压(DBP)、立位DBP高于对照组(P<0.05)。治疗后,观察组的健康调查简表(SF-36)各维度评分高于对照组(P<0.05)。治疗后,观察组的高密度脂蛋白胆固醇(HDL-C)、脂蛋白(a)[Lp(a)]、空腹血糖(FPG)、血尿素氮(BUN)、肌酐(Cr)及尿酸(UA)水平优于对照组(P<0.05)。结论 生脉饮合五苓散加味治疗老年高血压合并体位性低血压能明显改善临床症状,稳定血压,缩小脉压差,提高肾功能及生活质量。

Objective To explore the clinical effect of modified Shengmai Yin combined with Wuling powder in the treatment of orthostatic hypotension in elderly patients with hypertension.Methods A total of 265 senile hypertensive patients with orthostatic hypotension were divided into control group(133 cases)and observation group(132 cases)according to the random number table method.The control group was given routine medical treatment,and the observation group was given modified Shengmai Yin combined with Wuling powder on the basis of the control group.The therapeutic effects of the two groups were compared.Results The total effective rate of comprehensive treatment in the observation group was higher than that in the control group(P<0.01).After treatment,the supine systolic blood pressure(SBP),upright SBP and pulse pressure index(PPI)in the observation group were lower than those in the control group,while the supine diastolic blood pressure(DBP)and upright DBP were higher than those in the control group(P<0.05).After treatment,the scores of each dimension of the MOS 36-Item Short Form Health Survey(SF-36)in the observation group were higher than those in the control group(P<0.05).After treatment,the levels of high-density lipoprotein cholesterol(HDL-C),lipoprotein(a)[Lp(a)],fasting plasma glucose(FPG),blood urea nitrogen(BUN),creatinine(Cr)and uric acid(UA)in the observation group were better than those in the control group(P<0.05).Conclusion Modified Shengmai Yin combined with Wuling powder in the treatment of senile hypertension with orthostatic hypotension can significantly improve the clinical symptoms,stabilize blood pressure,reduce pulse pressure,improve renal function and quality of life.