桂枝加龙骨牡蛎汤治疗高血压伴失眠症62例
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摘要
目的观察桂枝加龙骨牡蛎汤加味治疗高血压伴失眠症的临床疗效。方法将124例高血压伴失眠症的患者随机分为2组:治疗组和对照组。对照组给予氯硝西泮片,每晚2 mg,口服;治疗组在对照组的基础上,加用中药,每日1剂,分2次温服;2组治疗时间均为4周。在治疗结束和治疗结束4周时分别观察临床疗效、匹兹堡睡眠质量指数(PSQI)总分、血压。结果在治疗结束时,治疗组与对照组总有效率相当(P>0.05)、PSQI总分都下降明显(P<0.05),而在治疗结束后4周时,治疗组总有效率明显高于对照组(P<0.05)、PSQI总分下降较为明显(P<0.05);在治疗结束和治疗结束后4周时,2组都能明显降低患者的基线血压,其中治疗组更为明显(P<0.05)。结论桂枝加龙骨牡蛎汤联合西药治疗高血压伴失眠症疗效显著,另外,其在改善睡眠的同时可以协助降压,值得推广。
Objective To observe the clinical curative effect of modified Guizhi and Longgu Muli decoction in the treatment of hyper-tension with insomnia. Methods 124 cases of patients with hypertension with insomnia were randomized equally into the control group which were treated with clonazepam piece in a dose of 5mg each night and the treatment group which was given traditional Chinese medicine on the basis of the control group, a dose per day, which was divided into two parts, one part once in a proper tem-perature. The period of treatment was 4 weeks. Then the clinical curative effect, the score of Pittsburgh Sleep Quality Index(PSQI), blood pressure at the end and after the end of the test were observed. Results At the end of the treatment, the total efficiency of the treatment group and the control group was roughly equal( P>0.05), the score of PSQI decreased significantly( P<0.05).After 4 weeks, the effective rate of the treatment group was significantly higher than that of the control group( P<0.05), the score of PSQI of the treatment group dropped more obviously than that of the control group( P<0.05), the blood pressure in the two observation period both decreased, while the treatment group obtained better effect( P<0.05). Conclusion The modified Guizhi and Longgu Muli decoction in the treatment of hypertension with insomnia had significantly curative effect. Meanwhile, it could improve the sleep,and helps to reduce blood pressure. So, it is worth promoting.
Objective To observe the clinical curative effect of modified Guizhi and Longgu Muli decoction in the treatment of hyper-tension with insomnia. Methods 124 cases of patients with hypertension with insomnia were randomized equally into the control group which were treated with clonazepam piece in a dose of 5mg each night and the treatment group which was given traditional Chinese medicine on the basis of the control group, a dose per day, which was divided into two parts, one part once in a proper tem-perature. The period of treatment was 4 weeks. Then the clinical curative effect, the score of Pittsburgh Sleep Quality Index(PSQI), blood pressure at the end and after the end of the test were observed. Results At the end of the treatment, the total efficiency of the treatment group and the control group was roughly equal( P>0.05), the score of PSQI decreased significantly( P<0.05).After 4 weeks, the effective rate of the treatment group was significantly higher than that of the control group( P<0.05), the score of PSQI of the treatment group dropped more obviously than that of the control group( P<0.05), the blood pressure in the two observation period both decreased, while the treatment group obtained better effect( P<0.05). Conclusion The modified Guizhi and Longgu Muli decoction in the treatment of hypertension with insomnia had significantly curative effect. Meanwhile, it could improve the sleep,and helps to reduce blood pressure. So, it is worth promoting.
引文
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[2]王彭辉,刘玉华,刘勇,等.高血压患者失眠原因与护理体会[J].临床误诊误治,2010(S1):116-117.
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[8]肖雪,张艳.高血压与失眠相关性研究[J].辽宁中医药大学学报,2012,(12):119-120.
[9]姚晓天,窦丽萍,高东升,等.高血压合并失眠的中医证型研究[J].浙江中西医结合杂志,2012(6):494-495.
[10]殷子杰,程志清,崔小强.高血压合并失眠理论浅析及治疗进展[J].中西医结合心脑血管病杂志,2009(3):335-336.
[11]邵大飞,张元兴.张元兴治疗失眠经验述要[J].河南中医,2011(11):1231-1232.
[12]贺玉琢,李晓琴,郭淑英,等.桂枝汤的药理学研究七、桂枝汤和桂技加厚朴杏子、桂技加龙骨牡骊汤的药理作用比较[J].中药药理与临床,1997:(1)1-4.
[13]江苏新医学院.中药大辞典.上册[S].上海:上海人民出版社,1975:626.
[14]袁昌鲁,王中博,焦莹,等.酸枣仁中黄酮类镇静催眠有效成分的研究[J].中药通报,1987,12(3):34.
[15]Masayuki Yoshikawa,Toshiyuki Murakami,Akira Ikebata.Bioactiv e Saponins and Glycosides X.On the Constituents of Zizyphi Spinosi Semen,the Seeds of Zizyphus jujuba Mill.Var.Spinosa Hu(1):Structures and Histamine Release-Inhibitory Effect of Jujubosides A1 and C and Acetyljujuboside B.Chem.Pharm.Bull.1997;45(7):1186.
[16]李海生,王安林,于利人.柏子仁单方注射液对睡眠模型猫影响的实验研究[J].天津中医学院学报,2000,19(3):38-40.
[17]杨俊业,徐建国,周玲,等.夜交藤煎剂的镇静催眠作用[J].华西医科大学学报,1990,21(2):175-177.
[18]霍长虹,郝存书,李作平,等.合欢皮水煎剂催眠作用的药理实验研究[J].河北医科大学学报,2002,23(4):216-217.
[19]陈凌云,杨国祥.半夏药理研究概况[J].云南中医学院学报,1997,20(4):17-19.
[20]徐明,余璐,丁媛媛,等.桂皮醛对麻醉大鼠降血压作用的实验研究[J].心脏杂志,2006(3):272-276.
[21]史青.肉桂和肉桂醛对氧自由基诱导的自发性高血压大鼠离体主动脉收缩的抑制作用[J].国外医学·中医中药分册,2003(2):95-96.
[22]梁健钦,熊万娜,罗远,等.夏枯草提取物对大鼠自发性高血压降血压作用研究[J].中药材,2011(1):99-100.
[2]王彭辉,刘玉华,刘勇,等.高血压患者失眠原因与护理体会[J].临床误诊误治,2010(S1):116-117.
[3]吴蕾.高血压病的睡眠质量与血压节律相关性的研究[D].北京:北京中医药大学,2014.
[4]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].中华心血管杂志,2011,39(7):579-615.
[5]中华医学会神经病学分会睡眠障碍学组.中国成人失眠诊断与治疗指南[J].中华神经科杂志,2012,45(7):534-540.
[6]刘贤臣.匹兹堡睡眠质量指数的信度效度研究[J].中华精神科杂志,1996,29(2):103-107.
[7]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:74-75.
[8]肖雪,张艳.高血压与失眠相关性研究[J].辽宁中医药大学学报,2012,(12):119-120.
[9]姚晓天,窦丽萍,高东升,等.高血压合并失眠的中医证型研究[J].浙江中西医结合杂志,2012(6):494-495.
[10]殷子杰,程志清,崔小强.高血压合并失眠理论浅析及治疗进展[J].中西医结合心脑血管病杂志,2009(3):335-336.
[11]邵大飞,张元兴.张元兴治疗失眠经验述要[J].河南中医,2011(11):1231-1232.
[12]贺玉琢,李晓琴,郭淑英,等.桂枝汤的药理学研究七、桂枝汤和桂技加厚朴杏子、桂技加龙骨牡骊汤的药理作用比较[J].中药药理与临床,1997:(1)1-4.
[13]江苏新医学院.中药大辞典.上册[S].上海:上海人民出版社,1975:626.
[14]袁昌鲁,王中博,焦莹,等.酸枣仁中黄酮类镇静催眠有效成分的研究[J].中药通报,1987,12(3):34.
[15]Masayuki Yoshikawa,Toshiyuki Murakami,Akira Ikebata.Bioactiv e Saponins and Glycosides X.On the Constituents of Zizyphi Spinosi Semen,the Seeds of Zizyphus jujuba Mill.Var.Spinosa Hu(1):Structures and Histamine Release-Inhibitory Effect of Jujubosides A1 and C and Acetyljujuboside B.Chem.Pharm.Bull.1997;45(7):1186.
[16]李海生,王安林,于利人.柏子仁单方注射液对睡眠模型猫影响的实验研究[J].天津中医学院学报,2000,19(3):38-40.
[17]杨俊业,徐建国,周玲,等.夜交藤煎剂的镇静催眠作用[J].华西医科大学学报,1990,21(2):175-177.
[18]霍长虹,郝存书,李作平,等.合欢皮水煎剂催眠作用的药理实验研究[J].河北医科大学学报,2002,23(4):216-217.
[19]陈凌云,杨国祥.半夏药理研究概况[J].云南中医学院学报,1997,20(4):17-19.
[20]徐明,余璐,丁媛媛,等.桂皮醛对麻醉大鼠降血压作用的实验研究[J].心脏杂志,2006(3):272-276.
[21]史青.肉桂和肉桂醛对氧自由基诱导的自发性高血压大鼠离体主动脉收缩的抑制作用[J].国外医学·中医中药分册,2003(2):95-96.
[22]梁健钦,熊万娜,罗远,等.夏枯草提取物对大鼠自发性高血压降血压作用研究[J].中药材,2011(1):99-100.