益心活血降压汤联合氢氯噻嗪治疗气虚血瘀型高血压患者的效果

Effects of Yixin Huoxue Jiangya decoction combined with Hydrochlorothiazide in treatment of patients with hypertension of qi deficiency and blood stasis type

目的:观察益心活血降压汤联合氢氯噻嗪治疗气虚血瘀型高血压患者的效果。方法:回顾性分析2019年9月至2021年9月于该院就诊的78例气虚血瘀型高血压患者的临床资料,按照治疗方法不同将其分为对照组和观察组各39例。对照组予以氢氯噻嗪治疗,观察组在对照组基础上联合益心活血降压汤治疗,连续用药8周。比较两组临床疗效,治疗前后血压指标(收缩压、舒张压、24 h平均收缩压、24 h平均舒张压)水平、中医证候积分、血液流变学指标[全血高切黏度(HBV)、血浆黏度(PV)、全血低切黏度(LBV)、血细胞比容(HCT)]水平,以及不良反应发生率。结果:观察组治疗总有效率为97.44%(38/39),高于对照组的79.49%(31/39),差异有统计学意义(P<0.05);治疗后,观察组收缩压、舒张压、24 h平均收缩压、24 h平均舒张压水平均低于对照组,差异有统计学意义(P<0.05);治疗后,观察组主症、次症等中医证候积分均低于对照组,差异有统计学意义(P<0.05);治疗后,观察组HBV、PV、HCT、LBV水平均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:益心活血降压汤联合氢氯噻嗪治疗气虚血瘀型高血压患者可提高治疗总有效率,降低血压指标水平、中医证候积分和血液流变学指标水平,效果优于单纯氢氯噻嗪治疗。

Objective:To observe effects of Yixin Huoxue Jiangya decoction combined with Hydrochlorothiazide in treatment of patients with hypertension of qi deficiency and blood stasis type.Methods:The clinical data of 78 patients with hypertension of qi deficiency and blood stasis type who were treated in the hospital from September 2019 to September 2021 were retrospectively analyzed.According to different treatment methods,they were divided into control group and observation group,39 cases in each group.The control group was treated with Hydrochlorothiazide,while the observation group was treated with Yixin Huoxue Jiangya decoction on the basis of that of the control group.They were continuously treated for 8 weeks.The clinical efficacy,the blood pressure index(systolic blood pressure,diastolic blood pressure,24 h average systolic blood pressure,24 h average diastolic blood pressure)levels,the TCM syndrome score,the hemorheology indexes[whole blood high shear viscosity(HBV),plasma viscosity(PV),whole blood low shear viscosity(LBV),hematocrit(HCT)]levels,and the incidence of adverse reactions were compared between the two groups before and after the treatment.Results:The total effective rate of the observation group was 97.44%(38/39),which was higher than 79.49%(31/39)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of systolic blood pressure,diastolic blood pressure,24 h mean systolic blood pressure and 24 h mean diastolic blood pressure in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the scores of TCM syndromes such as main symptoms and secondary symptoms in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of HBV,PV,HCT and LBV in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Yixin Huoxue Jiangya decoction combined with Hydrochlorothiazide can improve the total effective rate of treatment,reduce the levels of blood pressure indexes,the TCM syndrome scores and the levels of hemorheology indexes in the patients with hypertension of qi deficiency and blood stasis type.Moreover,it is superior to single Hydrochlorothiazide treatment.