恒清汤联合马来酸左旋氨氯地平片对原发性高血压患者血压昼夜节律、血压变异性及晨峰血压的影响
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摘要
目的观察恒清汤联合马来酸左旋氨氯地平片对原发性高血压患者血压昼夜节律、血压变异性及晨峰血压的影响。方法将110例原发性高血压患者随机分为治疗组和对照组各55例。对照组予马来酸左旋氨氯地平片,每次2.5 mg,每日1次,口服;治疗组在对照组基础上予恒清汤,每日1剂,每日2次,口服。2组均连续治疗8周。观察2组患者治疗前后血压昼夜节律及相关动态血压参数变化。结果与本组治疗前比较,治疗组治疗后日间平均收缩压(d SBP)、日间平均舒张压(d DBP)、夜间平均收缩压(n SBP)、收缩压昼夜节律、清晨SBP、清晨DBP、晨峰SBP均明显下降,杓型血压比率提高,血压变异性降低,晨峰血压升高比例下降,差异有统计学意义(P<0.05);对照组d SBP、n SBP明显下降,差异有统计学意义(P<0.05);2组治疗后比较,治疗组d SBP、n SBP、清晨SBP下降明显,收缩压昼夜节律、舒张压昼夜节律显著改善,2组比较差异有统计学意义(P<0.05),治疗组血压杓型血压比率高于对照组(P<0.05),血压变异性、晨峰SBP及晨峰血压升高比例低于对照组(P<0.05)。结论恒清汤联合马来酸左旋氨氯地平片可有效改善原发性高血压患者血压昼夜节律,降低血压变异性,提高杓型血压比率,并有效控制晨峰血压,改善相关动态血压参数。
Objective To observe the effects of Hengqing Decoction combined with levoamlodipine maleate tablets on the circadian rhythm, blood pressure variation and morning blood pressure surge in patients with primary hypertension. Methods Totally 110 patients with primary hypertension were randomly divided into treatment group and control group, with 55 cases in each group. The control group was treated with levoamlodipine maleate tablets 2.5 mg per time, once a day, orally, while the treatment group was treated with Hengqing Decoction on the basis of the control group, one dosage a day, twice a day, orally. Treatment course for both groups was 8 weeks. The changes of circadian rhythm and related dynamic blood pressure parameters of both groups before and after treatment were observed. Results Compared with before treatment, average day systolic blood pressure(d SBP), average day diastolic blood pressure(d DBP), average night systolic blood pressure(n SBP), SBP circadian rhythm, SBP and DBP in the morning, morning surge SBP in the treatment group decreased significantly; arytenoid blood pressure propotion increased; blood pressure variability decreased; morning blood pressure surge increase proportion decreased, with statistical significance(P<0.05). d SBP and n SBP in the control group after the treatment decreased significantly, with statistical significance(P<0.05). After treatment, d SBP, n SBP and morning SBP in the control group decreased significantly; SBP circadian rhythm and DBP circadian rhythm were improved, with statistical significance(P<0.05). Arytenoid blood pressure proportion in the treatment group was higher than the control group(P<0.05); The blood pressure variability rate, morning surge SBP blood pressure and morning surge blood pressure increase proportion were lower than the control group(P<0.05). Conclusion Hengqing Decoction combined with levoamlodipine maleate tablets can effectively improve blood pressure circadian rhythm, decrease blood pressure variability, increase arytenoid blood pressure proportion, effectively control morning surge blood pressure, and improve the related dynamic blood pressure parameters.
Objective To observe the effects of Hengqing Decoction combined with levoamlodipine maleate tablets on the circadian rhythm, blood pressure variation and morning blood pressure surge in patients with primary hypertension. Methods Totally 110 patients with primary hypertension were randomly divided into treatment group and control group, with 55 cases in each group. The control group was treated with levoamlodipine maleate tablets 2.5 mg per time, once a day, orally, while the treatment group was treated with Hengqing Decoction on the basis of the control group, one dosage a day, twice a day, orally. Treatment course for both groups was 8 weeks. The changes of circadian rhythm and related dynamic blood pressure parameters of both groups before and after treatment were observed. Results Compared with before treatment, average day systolic blood pressure(d SBP), average day diastolic blood pressure(d DBP), average night systolic blood pressure(n SBP), SBP circadian rhythm, SBP and DBP in the morning, morning surge SBP in the treatment group decreased significantly; arytenoid blood pressure propotion increased; blood pressure variability decreased; morning blood pressure surge increase proportion decreased, with statistical significance(P<0.05). d SBP and n SBP in the control group after the treatment decreased significantly, with statistical significance(P<0.05). After treatment, d SBP, n SBP and morning SBP in the control group decreased significantly; SBP circadian rhythm and DBP circadian rhythm were improved, with statistical significance(P<0.05). Arytenoid blood pressure proportion in the treatment group was higher than the control group(P<0.05); The blood pressure variability rate, morning surge SBP blood pressure and morning surge blood pressure increase proportion were lower than the control group(P<0.05). Conclusion Hengqing Decoction combined with levoamlodipine maleate tablets can effectively improve blood pressure circadian rhythm, decrease blood pressure variability, increase arytenoid blood pressure proportion, effectively control morning surge blood pressure, and improve the related dynamic blood pressure parameters.
引文
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[9]张勤,杨云梅,余国友.天麻素注射液对老年难治性高血压患者血压和血管活性物质影响的随机对照研究[J].中西医结合学报,2008,6(7):695-699.
[10]宋雪云.钩藤方提取物对自发性高血压大鼠降压作用的研究[J].中国实验方剂学杂志,2012,18(11):216-218.
[11]SHIH C H,LIN Y J,CHEN C M,et al.Butylidenephthalide antagonizes cromakalim-induced systolic pressure reduction in conscious normotensive rats[J].BMC Complement Altern Med,2015,15:344.
[12]孟胜喜,霍清萍.丹参及其有效成分对神经系统的作用[J].中国中医药信息杂志,2017,24(3):121-124.
[13]黄帧桧,张培,杨帆,等.葛根素对肾性高血压大鼠apelin-12、AngⅡ及NO含量与血压的影响[J].中国病理生理杂志,2011,27(12):2323-2327.
[14]孟胜喜,霍清萍.地龙及其有效成分对神经系统疾病的作用[J].山东中医杂志,2016,35(10):933-936.
[2]PALATINI P,REBOLDI G,BEILIN L J,et al.Added predictive value of night-time blood pressure variability for cardiovascular events and mortality:the Ambulatory Blood PressureInternational Study[J].Hypertension,2014,64(3):487-493.
[3]孟胜喜,霍清萍,王兵,等.复方恒清汤联合马来酸左旋氨氯地平治疗高血压性眩晕的临床疗效[J].中西医结合心脑血管病杂志,2018,16(5):528-532.
[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].中华高血压杂志,2011,19(8):701-743.
[5]张维忠.血压变异和晨峰的概念及临床意义[J].中华心血管病杂志,2006,34(1):287-288.
[6]HERMIDA R C,AYALA D E,MOJóN A,et al.Sleep-time BP:prognostic marker of type 2 diabetes and therapeutic target for prevention[J].Diabetologia,2016,59(2):244-254.
[7]孟胜喜,霍清萍,王兵,等.恒清汤治疗椎-基底动脉供血不足性眩晕的临床研究[J].中西医结合心脑血管病杂志,2017,15(1):17-20.
[8]孟胜喜,霍清萍,王兵,等.恒清汤对椎-基底动脉供血不足性眩晕作用的临床观察及其机制研究[J].中华中医药学刊,2017,35(5):1236-1239.
[9]张勤,杨云梅,余国友.天麻素注射液对老年难治性高血压患者血压和血管活性物质影响的随机对照研究[J].中西医结合学报,2008,6(7):695-699.
[10]宋雪云.钩藤方提取物对自发性高血压大鼠降压作用的研究[J].中国实验方剂学杂志,2012,18(11):216-218.
[11]SHIH C H,LIN Y J,CHEN C M,et al.Butylidenephthalide antagonizes cromakalim-induced systolic pressure reduction in conscious normotensive rats[J].BMC Complement Altern Med,2015,15:344.
[12]孟胜喜,霍清萍.丹参及其有效成分对神经系统的作用[J].中国中医药信息杂志,2017,24(3):121-124.
[13]黄帧桧,张培,杨帆,等.葛根素对肾性高血压大鼠apelin-12、AngⅡ及NO含量与血压的影响[J].中国病理生理杂志,2011,27(12):2323-2327.
[14]孟胜喜,霍清萍.地龙及其有效成分对神经系统疾病的作用[J].山东中医杂志,2016,35(10):933-936.