摘要
目的：评价黄连解毒汤加味治疗顽固性高血压的疗效。方法本研究为随机对照研究。将符合纳入标准的90例顽固性高血压患者按随机数字表分为2组各45例，对照组口服厄贝沙坦氢氯噻嗪片和硝苯地平控释片治疗，治疗组在对照组基础上联合应用黄连解毒汤加味。共4周。采用放射免疫法检测血浆内皮素（endothelin, ET）、降钙素基因相关肽（calcitonin gene related peptide, CGRP）以探讨药物的作用机制。结果治疗组与对照组证候疗效总有效率分别为86.7%（29/45）、64.4%（39/45），2组比较差异有统计学意义（χ^2＝4.873， P＝0.027）。治疗后，治疗组收缩压[（119.26±9.34）mmHg 比（172.11±10.52）mmHg，t＝25.201]、舒张压[（78.18±7.21）mmHg比（111.12±11.16）mmHg，t＝16.631]；对照组收缩压[（145.21±7.56）mmHg比（171.32±11.15）mmHg，t＝13.002]、舒张压[（93.57±8.13）mmHg比（109.89±12.21）mmHg，t＝7.463]均较同组治疗前降低（P＜0.01），且治疗组收缩压、舒张压均低于对照组（t 值分别为14.487、9.501，P＜0.01）。治疗组与对照组降压疗效总有效率分别为73.3%（33/45）、55.6%（25/45），2组比较差异无统计学意义（χ^2＝2.376，P＝0.123）。治疗组ET[（75.68±10.67）ng/L比（112.79±12.26）ng/L， t＝15.317]较对照组降低（P＜0.05），CGRP [（49.87±4.75）ng/L比（33.87±7.89）ng/L，t＝11.654]较对照组升高（P＜0.05）。结论黄连解毒汤可有效治疗顽固性高血压，其机制可能与降低血浆ET和升高CGRP水平有关。
Objective To evaluate the therapeutic effect of modifiedHuanglian-Jiedudecoction for resistant hypertension and explore its possible mechanism.Methods A total of 90 patients with resistant hypertension were recruited and randomly divided into a treatment group and a control group, 45 patients in each group. The control group was treated with oral administration of irbesartan and hydrochlorothiazide tablets and controlled-release nifedipine tablets, while the treatment group was further added modifiedHuanglian-Jiedu decoction for 4 weeks. Plasma endothelin （ET） and calcitonin gene-related peptide （CGRP） were measured by radioimmunoassay.Rusults The total efficiency according to the TCM syndrome in the treatment group was 86.7%（39/45） which was higher than 64.4%（29/45） in the control group（χ^2=4.873,P=0.027）. The systolic blood pressure （SBP） and diastolic blood pressure （DBP） decreased after the treatment in both groups （ SBP in the treatment group： 119.26 ± 9.34 mmHgvs.172.11 ± 10.52 mmHg,t=25.201,P〈0.01; DBP in the treatment group： 78.18 ± 7.21 mmHgvs.111.12 ± 11.16 mmHg,t=16.631, P〈0.01; SBP in the control group： 145.21 ± 7.56 mmHgvs.171.32 ± 11.15 mmHg,t=13.002,P〈0.01; DBP in the control group： 93.57±8.13 mmHgvs. 109.89 ± 12.21 mmHg,t=7.463,P〈0.01）, while the decrease of SBP （t=14.487,P〈0.01） and DBP （t=9.501, P〈0.01） in the treatment group was more greater than those in the control group. The control rate of blood pressure in the treatment and control groups were 73.3% （33/45） and 55.6% （25/45）, respectively, there had no significant difference （χ^2=2.376,P=0.123）. The plasma ET in the treatment group was significantly decreased than that in the control group （75.68 ± 10.67 ng/Lvs.112.79 ± 12.26ng/L;t=15.317,P〈0.05）, and CGRP significantly increased （49.87 ± 4.75 ng/Lvs.33.87 ± 7.89 ng/L;t=11.654,P〈0.05）.Conclusion Modified Huanglian-Jiedudecoction may have some therapeutic effect for resistant hypertension, its mechanism may be involved in ET decreasing and CGRP increasing.
出处
《国际中医中药杂志》
2015年第7期598-601,共4页
International Journal of Traditional Chinese Medicine
关键词
高血压
抗药性
抗高血压药:黄连解毒汤
内皮缩血管肽类
降钙素基因相关肽
Hypertension
Drug resistance
Antihypertensive agents
Huang Lian Jie Du Tang
Endothelins
Calcitonin gene-related peptide
