平肝安神汤对中青年高血压病患者血肾素、血管紧张素和醛固酮的影响
|
摘要
【目的】观察平肝安神汤对中青年高血压病阴虚阳亢证患者血中肾素(PRA)、血管紧张素Ⅱ(AngⅡ)和醛固酮(ALD)水平的影响。【方法】将64例中青年高血压病阴虚阳亢证患者随机分为治疗组和对照组,每组各32例。2组患者均给予厄贝沙坦片治疗,在此基础上,治疗组加用平肝安神汤治疗,疗程均为8周。观察2组患者治疗前后的血压、中医证候评分和血中PRA、AngⅡ和ALD水平的变化情况。【结果】(1)治疗8周后,治疗组的总有效率为87.50%,对照组为78.13%,治疗组的降压疗效优于对照组(P <0.05)。(2)治疗后,2组患者的收缩压、舒张压均较治疗前明显下降(P <0.01),且治疗组的降压作用明显优于对照组(P <0.05)。(3)治疗后,治疗组的各项中医证候评分均较治疗前明显下降(P <0.01),而对照组仅眩晕、头痛2项评分较治疗前降低(P <0.01);组间比较,治疗组在改善各项中医证候评分方面均明显优于对照组(P <0.01)。(4)治疗后,治疗组血中PRA水平升高,AngⅡ和ALD水平降低(P <0.01);而对照组血中PRA、AngⅡ和ALD水平虽有改善趋势,但差异均无统计学意义(P> 0.05)。治疗组在升高PRA水平和降低AngⅡ和ALD水平方面均优于对照组(P <0.05)。【结论】平肝安神汤与厄贝沙坦片联合治疗中青年高血压病阴虚阳亢证患者,其降压疗效显著,可明显改善患者的临床症状,其作用机制可能与升高血中PRA水平和降低血中AngⅡ和ALD水平有关。
Objective To observe the effects of Pinggan Anshen Decoction on plasma rennin activity(PRA),angiotensinⅡ(AngⅡ)and aldosterone(ALD)in young and middle-aged hypertension patients with the syndromeof hyperactive Yang due to Yin deficiency. Methods Sixty-four young and middle-aged hypertension patients withthe syndrome of hyperactive Yang due to Yin deficiency were randomly divided into treatment group and controlgroup, 32 cases in each group. Both groups were given oral use of Irbesartan Tablets, and additionally, thetreatment group was orally given Pinggan Anshen Decoction for 8 weeks. Blood pressure, traditional Chinesemedicine(TCM)symptom scores,and blood levels of PRA,Ang-Ⅱ and ALD of the two groups were observedbefore and after treatment. Results(1)After treatment, the total effective rate in the treatment group and thecontrol group was 87.50% and 78.13% respectively, the treatment group showing stronger effect on decreasingblood pressure than the control group(P < 0.05).(2)After treatment,systolic blood pressure and diastolic bloodpressure of the two groups were significantly decreased after treatment(P < 0.01 compared with those beforetreatment),and the treatment group had stronger effect on decreasing blood pressure than the control group(P <0.05).(3)After treatment,the scores of each TCM symptom of the treatment group were decreased(P < 0.01 compared with those before treatment),while in the control group only the scores of dizziness and headache weredecreased(P < 0.01);the treatment group had stronger effect on improving TCM symptom scores than the controlgroup(P < 0.01).(4)PRA level was increased, and AngⅡ and ALD levels were decreased in the treatment group after treatment(P < 0.01 compared with those before treatment), but the above indexes showed nosignificant changes in the control group(P > 0.05). The treatment group had stronger effect on increasing PRAlevel and on decreasing AngⅡ and ALD levels than the control group(P < 0.05). Conclusion Pinggan Anshen Decoction combined with Irbesartan Tablets is effective for the treatment of young and middle-aged patientshypertension with hyperactive Yang due to Yin deficiency by decreasing blood pressure and relieving clinicalsymptoms,and the mechanism may be related to elevating PRA level and decreasing AngⅡand ALD levels in theblood.
Objective To observe the effects of Pinggan Anshen Decoction on plasma rennin activity(PRA),angiotensinⅡ(AngⅡ)and aldosterone(ALD)in young and middle-aged hypertension patients with the syndromeof hyperactive Yang due to Yin deficiency. Methods Sixty-four young and middle-aged hypertension patients withthe syndrome of hyperactive Yang due to Yin deficiency were randomly divided into treatment group and controlgroup, 32 cases in each group. Both groups were given oral use of Irbesartan Tablets, and additionally, thetreatment group was orally given Pinggan Anshen Decoction for 8 weeks. Blood pressure, traditional Chinesemedicine(TCM)symptom scores,and blood levels of PRA,Ang-Ⅱ and ALD of the two groups were observedbefore and after treatment. Results(1)After treatment, the total effective rate in the treatment group and thecontrol group was 87.50% and 78.13% respectively, the treatment group showing stronger effect on decreasingblood pressure than the control group(P < 0.05).(2)After treatment,systolic blood pressure and diastolic bloodpressure of the two groups were significantly decreased after treatment(P < 0.01 compared with those beforetreatment),and the treatment group had stronger effect on decreasing blood pressure than the control group(P <0.05).(3)After treatment,the scores of each TCM symptom of the treatment group were decreased(P < 0.01 compared with those before treatment),while in the control group only the scores of dizziness and headache weredecreased(P < 0.01);the treatment group had stronger effect on improving TCM symptom scores than the controlgroup(P < 0.01).(4)PRA level was increased, and AngⅡ and ALD levels were decreased in the treatment group after treatment(P < 0.01 compared with those before treatment), but the above indexes showed nosignificant changes in the control group(P > 0.05). The treatment group had stronger effect on increasing PRAlevel and on decreasing AngⅡ and ALD levels than the control group(P < 0.05). Conclusion Pinggan Anshen Decoction combined with Irbesartan Tablets is effective for the treatment of young and middle-aged patientshypertension with hyperactive Yang due to Yin deficiency by decreasing blood pressure and relieving clinicalsymptoms,and the mechanism may be related to elevating PRA level and decreasing AngⅡand ALD levels in theblood.
引文
[1]杨振威.加味天麻钩藤饮联合络活喜治疗中青年肝阳上亢型高血压的临床研究[J].北京中医,2007,26(8):505.
[2]武颖,衷敬柏. 105例青年原发性高血压临床特点与疗效分析[J].北京中医药,2017,36(3):213.
[3]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华高血压杂志,2011,19(8):701.
[4]郑筱萸.中药新药临床研究指导原则(试行)[S].北京:中国医药科技出版社,2002:73.
[5]王朝晖,吴国,李滢,等.肾素—血管紧张素—醛固酮系统在原发性高血压病中的表达[J].放射免疫学杂志,2013,26(2):144.
[6]赵峻峰,刘生祥,杨金娟,等.活血通脉汤对高血压病患者肾素、血管紧张素Ⅱ、内皮素、同型半胱氨酸及降钙素基因相关肽的影响[J].浙江中医药大学学报,2012,36(1),1185.
[7] Das M, Pal S, Ghosh A. Angiotensin converting enzyme gene polymorphism(insertion/deletion)and hypertension in adult Asian Indians:a population-based study from Calcutts,India[J]. Hum Biol,2008,80(3):303.
[8]耿新军,高耀青,佘敏娟,等.高血压病不同分级和不同年龄中肾素—血管紧张素Ⅱ—醛固酮活性的相关性研究[J].陕西医学杂志,2011,40(8):957.
[9]徐璐璐,辛雅萍,张东铭,等.硝苯地平联合厄贝沙坦治疗糖尿病合并高血压的疗效[J].中国临床药理学杂志,2012,28(2):83.
[10]周倩仪,马楷奇,郭意欣,等.天麻钩藤饮联用血管紧张素转化酶抑制剂治疗原发性高血压的Meta分析[J].中国实验方剂学杂志,2015,21(4):2016.
[11]邬春晓,张京春,刘玥,等.补肾清肝方不同剂型对高血压阴虚阳亢证患者血压及血管紧张素Ⅱ水平的干预效应[J].中国老年学杂志,2013,33(4):1753.
[2]武颖,衷敬柏. 105例青年原发性高血压临床特点与疗效分析[J].北京中医药,2017,36(3):213.
[3]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华高血压杂志,2011,19(8):701.
[4]郑筱萸.中药新药临床研究指导原则(试行)[S].北京:中国医药科技出版社,2002:73.
[5]王朝晖,吴国,李滢,等.肾素—血管紧张素—醛固酮系统在原发性高血压病中的表达[J].放射免疫学杂志,2013,26(2):144.
[6]赵峻峰,刘生祥,杨金娟,等.活血通脉汤对高血压病患者肾素、血管紧张素Ⅱ、内皮素、同型半胱氨酸及降钙素基因相关肽的影响[J].浙江中医药大学学报,2012,36(1),1185.
[7] Das M, Pal S, Ghosh A. Angiotensin converting enzyme gene polymorphism(insertion/deletion)and hypertension in adult Asian Indians:a population-based study from Calcutts,India[J]. Hum Biol,2008,80(3):303.
[8]耿新军,高耀青,佘敏娟,等.高血压病不同分级和不同年龄中肾素—血管紧张素Ⅱ—醛固酮活性的相关性研究[J].陕西医学杂志,2011,40(8):957.
[9]徐璐璐,辛雅萍,张东铭,等.硝苯地平联合厄贝沙坦治疗糖尿病合并高血压的疗效[J].中国临床药理学杂志,2012,28(2):83.
[10]周倩仪,马楷奇,郭意欣,等.天麻钩藤饮联用血管紧张素转化酶抑制剂治疗原发性高血压的Meta分析[J].中国实验方剂学杂志,2015,21(4):2016.
[11]邬春晓,张京春,刘玥,等.补肾清肝方不同剂型对高血压阴虚阳亢证患者血压及血管紧张素Ⅱ水平的干预效应[J].中国老年学杂志,2013,33(4):1753.