化痰脉通片对H型高血压痰瘀互结证患者血压及踝臂指数变化的影响
|
摘要
【目的】观察化痰脉通片对H型高血压痰瘀互结证患者血压及踝臂指数(ABI)变化的影响。【方法】根据血浆同型半胱氨酸(Hcy)水平,将80例H型高血压痰瘀互结型患者分为Hcy<25μmol/L组和Hcy≥25μmol/L组,每组各40例,各组再按1∶1比例随机分为试验组和对照组,共分为试验1组(Hcy<25μmol/L)、对照1组(Hcy<25μmol/L)、试验2组(Hcy≥25μmol/L)、对照2组(Hcy≥25μmol/L)4组,每组各20例。试验组给予化痰脉通片+苯磺酸氨氯地平+叶酸治疗,对照组给予苯磺酸氨氯地平+叶酸治疗,观察各组治疗前后动态血压[24 h收缩压(24hSBP)、24 h舒张压(24hDBP)、日间收缩压(DaySBP)、日间舒张压(DayDBP)、夜间收缩压(NightSBP)、夜间舒张压(NightDBP)]及ABI的变化情况。【结果】(1)当Hcy<25μmol/L时,治疗后,试验1组24hSBP、24hDBP、DaySBP、DayDBP、NightSBP、NightDBP均较治疗前改善,对照1组仅24hSBP、24hDBP、DaySBP、DayDBP较治疗前改善(P<0.05),试验1组在改善24hSBP、24hDBP、NightSBP、NightDBP方面优于对照1组(P<0.05)。当Hcy≥25μmol/L时,治疗后,试验2组24hSBP、24hDBP、DaySBP、DayDBP、NightSBP、NightDBP均较治疗前改善,对照2组仅24hSBP、DaySBP、DayDBP较治疗前改善(P<0.05),试验2组在改善24hSBP、24hDBP、DaySBP、DayDBP方面优于对照2组(P<0.05)。试验1组在改善24hSBP、24hDBP、NightSBP、NightDBP方面优于试验2组,差异均有统计学意义(P<0.05)。(2)治疗后,试验1组和试验2组的左、右ABI均较治疗前改善(P<0.05),而对照1组和对照2组的左、右ABI较治疗前无显著性改善(P>0.05)。组间比较,试验1组对左、右ABI的改善作用优于对照1组,试验2组对左、右ABI的改善作用优于对照2组(P<0.05),且试验1组对左、右ABI的改善作用优于试验2组,差异有统计学意义(P<0.05)。【结论】化痰脉通片可降低H型高血压患者血压,改善患者ABI水平,尤其对Hcy<25μmol/L时作用更明显,提示Hcy的分级有助于H型高血压的早期防治。
Objective To observe the effect of Huatan Maitong Tablets(HMT)on blood pressure and anklebrachial index(ABI)of H-type hypertension patients with the syndrome of phlegm blended with blood stasis.Methods According to the plasma homocysteine(Hcy)level,eighty cases of H-type hypertension patients withthe syndrome of phlegm blended with blood stasis were divided into group 1(Hcy<25 μmol/L)and group 2(Hcy ≥ 25 μmol/L),40 cases in each group. And then each group was evenly divided into trial group and controlgroup,i.e.,trial group 1,control group 1,trial group 2 and control group 2. The trial groups were given oral useof HMT+ Norvasc(Amlodipine Besylate)+folic acid,and the control groups were given oral use of Norvasc+folicacid. Before and after treatment,the changes of ambulatory blood pressure parameters of 24-hour systolic bloodpressure(24 hSBP),24-hour diastolic blood pressure(24 hDBP),day systolic blood pressure(DaySBP),daydiastolic blood pressure(DayDBP),night systolic blood pressure(NightSBP)and night diastolic blood pressure(NightDBP)as well as ABI were observed. Results(1)After treatment, all of the ambulatory blood pressureparameters in trial group 1(Hcy<25 μmol/L)were improved, while only 24 hSBP, 24 hDBP, DaySBP andDayDBP in control group 1 were improved(P<0.05 compared with those before treatment);and trial group 1 hadstronger effect on improving 24 hSBP,24 hDBP,NightSBP and NightDBP than control group 1(P<0.05). In trailgroup 2(Hcy ≥ 25μmol/L),all of the ambulatory blood pressure parameters were also improved after treatment,and the parameters of 24 hSBP,DaySBP and DayDBP in control group 2 were also improved(P<0.05 comparedwith those before treatment); trial group 2 had stronger effect on improving 24 hSBP, 24 hDBP, DaySBP andDayDBP than control group 2(P<0.05). Trial group 1 had stronger effect on improving 24 hSBP, 24 hDBP,NightSBP and NightDBP than trial group 2(P<0.05).(2) After treatment,the left and right ABI were improvedin trial group 1 and trial group 2(P < 0.05),while showed no obvious changes in control group 1 and controlgroup 2(P > 0.05). The intergroup comparison results showed that the improvement of left and right ABI in trialgroup 1 was superior to control group 1,so did that in trial group 2 to control group 2 and that in trial group 1 totrial group 2,the difference being significant(P < 0.05). Conclusion HMT can significantly improve the bloodpressure and ABI of H-type hypertension patients with the syndrome of phlegm blended with blood stasis, inparticular for the patients with Hcy<25 μmol/L. The results indicate that classification of Hcy level will be helpfulfor the early prevention and treatment of H-type hypertension.
Objective To observe the effect of Huatan Maitong Tablets(HMT)on blood pressure and anklebrachial index(ABI)of H-type hypertension patients with the syndrome of phlegm blended with blood stasis.Methods According to the plasma homocysteine(Hcy)level,eighty cases of H-type hypertension patients withthe syndrome of phlegm blended with blood stasis were divided into group 1(Hcy<25 μmol/L)and group 2(Hcy ≥ 25 μmol/L),40 cases in each group. And then each group was evenly divided into trial group and controlgroup,i.e.,trial group 1,control group 1,trial group 2 and control group 2. The trial groups were given oral useof HMT+ Norvasc(Amlodipine Besylate)+folic acid,and the control groups were given oral use of Norvasc+folicacid. Before and after treatment,the changes of ambulatory blood pressure parameters of 24-hour systolic bloodpressure(24 hSBP),24-hour diastolic blood pressure(24 hDBP),day systolic blood pressure(DaySBP),daydiastolic blood pressure(DayDBP),night systolic blood pressure(NightSBP)and night diastolic blood pressure(NightDBP)as well as ABI were observed. Results(1)After treatment, all of the ambulatory blood pressureparameters in trial group 1(Hcy<25 μmol/L)were improved, while only 24 hSBP, 24 hDBP, DaySBP andDayDBP in control group 1 were improved(P<0.05 compared with those before treatment);and trial group 1 hadstronger effect on improving 24 hSBP,24 hDBP,NightSBP and NightDBP than control group 1(P<0.05). In trailgroup 2(Hcy ≥ 25μmol/L),all of the ambulatory blood pressure parameters were also improved after treatment,and the parameters of 24 hSBP,DaySBP and DayDBP in control group 2 were also improved(P<0.05 comparedwith those before treatment); trial group 2 had stronger effect on improving 24 hSBP, 24 hDBP, DaySBP andDayDBP than control group 2(P<0.05). Trial group 1 had stronger effect on improving 24 hSBP, 24 hDBP,NightSBP and NightDBP than trial group 2(P<0.05).(2) After treatment,the left and right ABI were improvedin trial group 1 and trial group 2(P < 0.05),while showed no obvious changes in control group 1 and controlgroup 2(P > 0.05). The intergroup comparison results showed that the improvement of left and right ABI in trialgroup 1 was superior to control group 1,so did that in trial group 2 to control group 2 and that in trial group 1 totrial group 2,the difference being significant(P < 0.05). Conclusion HMT can significantly improve the bloodpressure and ABI of H-type hypertension patients with the syndrome of phlegm blended with blood stasis, inparticular for the patients with Hcy<25 μmol/L. The results indicate that classification of Hcy level will be helpfulfor the early prevention and treatment of H-type hypertension.
引文
[1]侯丹丹,甄攀攀,王雯.高同型半胱氨酸血症与内皮细胞凋亡[J].生理科学进展,2011,42(2):158.
[2] Malinowska J, Kolodiziejczyk J, Olas B. The disturbance of hemostasis induced by hyperhomocysteinemia,the role of antioxidants[J]. Acta Biochim Pol,2012,59(2):185.
[3] Hamelet J,Demuth K,Paul J L,et al. Hyperhomocysteinemia due to cystathionine beta synthase deficiency induces dysregulation of genes involved in hepatic lipid homeostasis in mice[J]. J Hepatol,2007,46(1):151.
[4] Sen U,Mishra P K,Tyagi N,et al. Homocysteine to hydrogen sulfide or hypertension[J]. Cell Biochem Biophys,2010,57(2-3):49.
[5]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].中华心血管病杂志,2011,39(7):53.
[6]中华中医药学会.中医内科常见病诊疗指南[M].北京:中国中医药出版社,2008.
[7] Granieri M,Bellisarii F I,De Caterina R. Group B vitamins as new variables related to the cardiovascular risk[J]. Ital Heart J Suppl,2005,6(1):1.
[8] Wald D S, Wald N J, Morris J K, et al. Folic acid,homocysteine, and cardiovascular disease:judging causality in the face of inconclusive trial evidence[J]. BMJ, 2006, 333:1114.
[9] Bazzno L A,Renolds K,Holder K N,et al. Effect of folic acid,supplementaion on risk of cardiovascular diseases:a metaanalysis of randomized controlled trials[J]. JAMA, 2006, 296(22):2720.
[10] Bonaa K H,Njolstad I,Ueland P W,et al. Homocysteine lowering and cardiovascular events after acute myocardial infarction[J]. N Engl J Med,2006,354(15):1578.
[11]马立青,杨小娟.高血压患者血压变异性临床分析[J].延安大学学报,2001,20(2):78.
[12]唐娜娜,方险峰,刘中勇. H型高血压与中医证型的相关性及其动态血压特点研究[J].中国全科医学, 2015,18(11):1240.
[13]王金玲.健脾化浊汤联合西药治疗H型高血压疗效观察[J].中国中医药信息杂志,2014,21(1):99.
[14]曾洁,何佳,张莉晶. H型高血压病痰瘀互结证相关因素的临床分析[J].天津中医药大学学报,2017,36(1):29.
[2] Malinowska J, Kolodiziejczyk J, Olas B. The disturbance of hemostasis induced by hyperhomocysteinemia,the role of antioxidants[J]. Acta Biochim Pol,2012,59(2):185.
[3] Hamelet J,Demuth K,Paul J L,et al. Hyperhomocysteinemia due to cystathionine beta synthase deficiency induces dysregulation of genes involved in hepatic lipid homeostasis in mice[J]. J Hepatol,2007,46(1):151.
[4] Sen U,Mishra P K,Tyagi N,et al. Homocysteine to hydrogen sulfide or hypertension[J]. Cell Biochem Biophys,2010,57(2-3):49.
[5]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].中华心血管病杂志,2011,39(7):53.
[6]中华中医药学会.中医内科常见病诊疗指南[M].北京:中国中医药出版社,2008.
[7] Granieri M,Bellisarii F I,De Caterina R. Group B vitamins as new variables related to the cardiovascular risk[J]. Ital Heart J Suppl,2005,6(1):1.
[8] Wald D S, Wald N J, Morris J K, et al. Folic acid,homocysteine, and cardiovascular disease:judging causality in the face of inconclusive trial evidence[J]. BMJ, 2006, 333:1114.
[9] Bazzno L A,Renolds K,Holder K N,et al. Effect of folic acid,supplementaion on risk of cardiovascular diseases:a metaanalysis of randomized controlled trials[J]. JAMA, 2006, 296(22):2720.
[10] Bonaa K H,Njolstad I,Ueland P W,et al. Homocysteine lowering and cardiovascular events after acute myocardial infarction[J]. N Engl J Med,2006,354(15):1578.
[11]马立青,杨小娟.高血压患者血压变异性临床分析[J].延安大学学报,2001,20(2):78.
[12]唐娜娜,方险峰,刘中勇. H型高血压与中医证型的相关性及其动态血压特点研究[J].中国全科医学, 2015,18(11):1240.
[13]王金玲.健脾化浊汤联合西药治疗H型高血压疗效观察[J].中国中医药信息杂志,2014,21(1):99.
[14]曾洁,何佳,张莉晶. H型高血压病痰瘀互结证相关因素的临床分析[J].天津中医药大学学报,2017,36(1):29.