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中医辨证治疗高血压伴失眠疗效观察

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目的 评价中医辨证治疗高血压伴失眠的有效性和安全性.方法 以 2019 年 1月—2021 年6 月在河南省中医药研究院附属医院及河南省人民医院治疗的高血压伴失眠患者作为研究对象,采用前瞻性非随机对照研究方法,根据患者是否应用中药分为中西医结合组和西医组,以倾向评分法匹配137 对患者,每组 137 例.2 组均予苯磺酸氨氯地平联合艾司唑仑治疗,中西医结合组在此基础上增加中药辨证治疗,2 组治疗周期均为8 周.比较2 组患者治疗前后血压、匹兹堡睡眠质量指数评定量表(PSQI)评分及中医证候积分,统计2 组血压、失眠、中医证候治疗疗效.结果 2 组治疗8 周后的血压、PSQI评分及中医证候积分均较治疗前明显降低(P均<0.05),且中西医结合组血压、PSQI评分及中医证候积分均明显低于对照组(P均<0.05).治疗 8 周后,中西医结合组的血压、失眠、中医证候疗效总有效率分别为 93.38%(127/136,该组缺失 1 例)、81.02%(111/137)、94.89%(130/137),均明显高于西医组的81.02%(111/137)、43.80%(60/137)、68.61%(94/137),差异均有统计学意义(P均<0.05).结论 中医辨证治疗能有效降低高血压伴失眠患者的血压,改善患者睡眠质量,减轻患者的临床症状.
Efficacy of traditional Chinese medicine based on differentiation on hypertension with insomnia
Objective It is to evaluate the effectiveness and safety of traditional Chinese medicine based on differentia-tion in the treatment of hypertension with insomnia.Methods The patients with hypertension with insomnia treated in the Affiliated Hospital of Henan Academy of Traditional Chinese Medicine and Henan Provincial People's Hospital from January 2019 to June 2021 were selected as the study subjects,and a prospective non-randomized controlled study method was used to classify the patients into the group of integrated traditional Chinese and western medicine(combination group)and west-ern medicine group according to whether they were treated with traditional Chinese medicine or not,and 137 pairs of pa-tients were matched with 137 cases in each group by the propensity score method.Both groups were treated with amlodipine benzenesulfonate combined with eszopiclone,and the combination group was additionally treated with traditional Chinese medicine based on differentiation,both groups were treated for 8 weeks.The blood pressure,scores of Pittsburgh Sleep Quality Index(PSQI)and traditional Chinese medicine syndromes of patients before and after treatment were compared be-tween the two groups,and the efficacies of blood pressure,insomnia,and traditional Chinese medicine syndromes in the two groups were assessed.Results After 8 weeks of treatment,the blood pressure,PSQI score and traditional Chinese med-icine syndrome scores of the two groups were significantly lower than those before treatment(all P<0.05),and the blood pressure,PSQI score and traditional Chinese medicine syndromes of the combination group were significantly lower than those of the control group(all P<0.05).After8 weeks of treatment,the total effective rates of blood pressure,insomnia,and traditional Chinese medicine syndromes in the combination group were93.38%(127/136,with1 case dropped in this group),81.02%(111/137),and 94.89%(130/137),respectively,which were significantly higher than those(81.02%(111/137),43.80%(60/137),68.61%(94/137)of the western medicine group,and the differences were all statistically significant(all P<0.05).Conclusion Therapy with traditional Chinese medicine based on differentiation can effectively reduce the blood pressure of patients with hypertension with insomnia,improve their sleep quality and allevi-ate clinical symptoms.

hypertensioninsomniadifferentiation and treatment of Chinese medicine

林萍、崔伟锋、柴丽、秦雷明、李玲、王风华、陈艳军、庆慧

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郑州大学第五附属医院,河南 郑州 450046

河南省中医药研究院,河南 郑州 450004

上海市第十人民医院,上海 200072

河南省人民医院,河南 郑州 450003

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高血压 失眠 倾向评分匹配法 中医辨证治疗

河南省中医药科学研究专项课题河南省中医药拔尖人才培养项目河南省中医药拔尖人才培养项目专项课题

2018ZY01019豫卫中医函[2021]15号2022ZYBJ25

2024

现代中西医结合杂志
中国中西医结合学会河北分会,中华中医药学会

现代中西医结合杂志

CSTPCD
影响因子:1.775
ISSN:1008-8849
年,卷(期):2024.33(10)