首页|益气温阳补肾方加减治疗老年高血压患者的临床疗效及对其血管内皮功能和血压控制效果的影响

益气温阳补肾方加减治疗老年高血压患者的临床疗效及对其血管内皮功能和血压控制效果的影响

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目的 探讨益气温阳补肾方加减治疗老年高血压脾肾阳虚证的临床效果.方法 选取2021年12月-2022年11月期间青岛市中医医院收治的脾肾阳虚证老年高血压患者98例,采用随机数字表法分为对照组和试验组,每组各49例.对照组给予常规西药降压治疗,试验组在对照组基础上联合益气温阳补肾方加减治疗,两组患者均治疗4周.观察比较两组患者临床疗效、治疗安全性,治疗前后中医证候积分、血压[收缩压(Sys-tolic blood pressure,SBP)、舒张压(Diastolic blood pressure,DBP)、脉压(Pulse pressure,PP)、24 h SBP、24 h DBP]水平、血管内皮功能指标[内皮素-1(Endothelin-1,ET-1)、一氧化氮(Nitric oxide,NO)、血栓素 A2(Thrombin A2,TXA2)]水平.结果 (1)临床疗效:治疗后试验组总有效率95.92%(47/49)明显高于对照组81.25%(39/48),差异有统计学意义(P<0.05).(2)中医证候积分:治疗后两组患者中医证候各项症状积分均较治疗前降低,差异有统计学意义(P<0.05);且试验组中医证候各项症状积分均明显低于对照组,差异有统计学意义(P<0.05).(3)血压监测水平:治疗后两组患者SBP、DBP、PP、24 h SBP、24 h DBP水平均较治疗前降低,差异有统计学意义(P<0.05);且试验组SBP、DBP、PP、24 h SBP、24 h DBP水平均明显低于对照组,差异有统计学意义(P<0.05).(4)血管内皮功能水平:治疗后两组患者血清ET-1、TXA2均较治疗前降低,NO较治疗前升高,差异有统计学意义(P<0.05);且试验组ET-1、TXA2均明显低于对照组,NO明显高于对照组,差异有统计学意义(P<0.05).(5)安全性:治疗期间,两组患者均未发生严重或影响治疗的不良反应,仅对照组出现1例轻度潮红,未给予干预自行缓解.结论 益气温阳补肾方加减治疗老年高血压脾肾阳虚证效果显著,安全性高,有利于控制患者血压水平,且可能与调节血管内皮功能有关.
The Clinical Efficacy of Yiqi Wenyang Bushen Formula with Modifications in Trea-ting Elderly Patients with Hypertension and Its Effects on Vascular Endothelial Function and Blood Pressure Control
Objective To investigate the clinical effect of the Yiqi Wenyang Bushen Formula with modifications in treating elderly patients with hypertension and spleen-kidney yang deficiency syndrome.Methods A total of 98 elder-ly hypertensive patients with spleen-kidney yang deficiency syndrome admitted to Qingdao Hospital of Traditional Chinese Medicine from December 2021 to November 2022,were selected and randomly divided into a control group and an experi-mental group,with 49 patients in each group.The control group was given conventional western antihypertensive treatment,while the experimental group received the Yiqi Wenyang Bushen Formula with modifications combined with conventional western antihypertensive treatment.Both groups were treated for 4 weeks.The clinical efficacy and treatment safety were ob-served and compared between the two groups,as well as traditional Chinese medicine(TCM)syndrome scores,blood pres-sure levels[systolic blood pressure(SBP),diastolic blood pressure(DBP),pulse pressure(PP),24 h SBP,24 h DBP],and vascular endothelial function indicators levels[endothelin-1(ET-1),nitric oxide(NO),thrombin A2(TXA2)]before and after treatment were observed and compared between the two groups.Results(1)Clinical efficacy:After treatment,a 95.92%total effective rate for the experimental group was significantly higher than the control group at 81.25%,with sta-tistical significance(P<0.05).(2)TCM syndrome scores:After treatment,the TCM symptom scores of all symptoms in both groups were lower than before treatment(P<0.05),and the scores in the experimental group were significantly lower than those in the control group(P<0.05).(3)Blood pressure levels:After treatment,the SBP,DBP,PP,24 h SBP,and 24 h DBP levels in both groups were lower than before treatment(P<0.05),and the levels in the experimental group were significantly lower than those in the control group(P<0.05).(4)Vascular endothelial function levels:After treatment,serum ET-1 and TXA2 levels in both groups were lower,while the NO levels were higher than before treatment(P<0.05);ET-1 and TXA2 levels in the experimental group were significantly lower,and NO levels were significantly higher than those in the control group(P<0.05).(5)Safety:During treatment,no serious or treatment-affecting adverse reac-tions occurred in either group.Only 1 case of mild flushing was observed in the control group,which was self-alleviated without intervention.Conclusion Yiqi Wenyang Bushen Formula with modifications is highly effective and safe in treating elderly patients with hypertension and spleen-kidney yang deficiency syndrome.It helps control the blood pressure level of patients and may be related to regulating vascular endothelial function.

Senile HypertensionSpleen-kidney Yang Deficiency SyndromeYiqi Wenyang Bushen Formula with ModificationsBlood Pressure LevelVascular Endothelial Function

解晓青、宋业琳、李洁

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青岛市中医医院肿瘤二科,山东青岛 266033

青岛市中医医院心血管三科,山东青岛 266033

青岛市中医医院心血管一科,山东青岛 266033

老年高血压 脾肾阳虚证 益气温阳补肾方加减 血压水平 血管内皮功能

青岛市卫生健康委中医药科研计划(2020)青岛市卫生健康委中医药科研计划(2020)

2020-zyy0082020-zyy005

2024

世界中西医结合杂志
中华中医药学会

世界中西医结合杂志

CSTPCD
影响因子:1.053
ISSN:1673-6613
年,卷(期):2024.19(5)
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