摘要
目的:探讨调冲平肝方治疗围绝经期高血压病患者的疗效及对血管内皮功能和神经内分泌功能的影响。方法:90例围绝经期高血压病患者随机按数字法分为观察组和对照组各45例。两组均给予心理辅导治疗。对照组采用谷维素片,20 mg,3次/d,非洛地平缓释片,5 mg,1次/d。观察组采用调冲平肝方,1剂/d,常规水煎分2次服用。疗程为8周。采用Kupperman指数(KI)记录围绝经期综合征症状;测定患者血压水平;检测血清雌二醇(E2)、促卵泡刺激素(FSH)、促黄体生成素(LH)、一氧化氮(NO)、内皮素1(ET-1)、神经肽Y(NPY)、神经降压肽(NT)及β-内啡肽(β-EP)水平。结果:治疗后第4周两组收缩压(SBP)、舒张压(DBP)水平均较治疗前降低(P<0.01),治疗后8周两组SBP,DBP水平进一步下降,观察组SBP,DBP水平均低于对照组(P<0.01);治疗后观察组血压复常率为68.89%,优于对照组的46.67%(P<0.05);观察组血压疗效有效率为93.33%优于对照组的73.33%(P<0.05);治疗后4周及疗程结束时观察组KI评分低于对照组(P<0.01),观察组KI评分下降幅度优于对照组(P<0.01);治疗后观察组E2水平高于对照组(P<0.05),FSH,LH水平低于对照组(P<0.01);治疗后观察组ET-1水平下降,并低于对照组(P<0.01),NO水平上升,并高于对照组(P<0.01);治疗后观察组NPY低于对照组,NT,β-EP水平高于对照组(P<0.05)。结论:在心理辅导治疗的基础上,调冲平肝方能改善围绝经期综合征患者临床症状,下降患者血压水平,促进患者血压恢复正常,其作用机制可能与其调节患者神经内分泌和改善血管内皮功能有关。
Objective： The purpose is to study the curative effect of Tiaochong Pinggan square on hypertension of patients in perimenopausal period and its influence on vascular endothelial function and neuroendocrine function. Method： Ninety cases of hypertension patients in perimenopausal period were randomly divided into control group （45 cases） and observation group （45 cases） according to digital method. The patients in both groups took psychological supportive treatment. Patients in control group took the oryzanol tablets （20 mg/ time, 3 times/day） and felodipine zyban tablets （5 rag/time, 1 time/day）. Patients in observation group took Tiaochong Pinggan square, 1 dose/day, 2 times/day, conventional water frying. Treatment course was 8 weeks. Kupperman index （KI） was used to record symptoms of perimenopausal syndrome, detecting blood pressure levels of patients. Levels of serum estradiol （ E2 ）, follicle-stimulating hormone （ FSH）, luteinizing hormone （ LH）,nitric oxide （NO）, endothelin 1 （ ET-1 ）, neuropeptide Y （NPY）, neural antihypertensive peptides （NT） and β- endorphin （fl-EP） were measured. Result： After treatment, in fourth week, levels of SBP and DBP in both groups reduced, compared to the state before treatment （P 〈 0.01 ）. In eighth week, levels of SBP and DBP in both groups fall further, observation group was lower than control group （P 〈 0.01 ）. The rate of blood pressure recover was 68.89% , superior to 46.67% in the control group （ P 〈 0.05 ）. The effect of blood pressure efficacy of observation group was 93.33% , better than 73.33% of control group （P 〈0.05 ）. In 4 weeks after treatment and the end of the treatment, KI score of the observation group was lower than the control group （P 〈0.01 ） , while the descend range of KI score in observation group was superior to the control group （P 〈 0.01 ）. After treatment, E2 level of observation group was higher than the control （P 〈 0.05） , but levels of FSH and LH were lower than the control group （P 〈 0.01 ）. ET-1 level of observation group declined and was lower than the control group （P 〈 0.01 ）. However, NO level of observation group increased and was higher than the control group （P 〈 0.01 ）. NPY of observation group was lower than the control group after treatment, while levels of NT and/3-EP were higher than the control group （P 〈 0.05）. Conclusion ： On the basis of psychological guidance treatment, Tiaochong Pinggan square can improve clinical symptoms of patients with perimenopausal syndrome, decreasing blood pressure level of patients and promoting the patients＂ blood pressure return to normal state. Its mechanism may be related to its regulation of vascular endothelial function and neuroendocrine function, which is worth of clinical use.
出处
《中国实验方剂学杂志》
CAS
北大核心
2013年第21期290-293,共4页
Chinese Journal of Experimental Traditional Medical Formulae
基金
宁夏回族自治区自然科学基金(N09190)
关键词
围绝经期综合征
高血压病
调冲平肝方
血管内皮功能
神经内分泌
perimenopausal syndrome
hypertension
Tiaochong Pinggan square
vascular endothelialfunction
neuroendocrine
