摘要
目的:探讨益气化痰法治疗老年难治性高血压的临床效果。方法:选取广东省人民医院2019年1月-2020年1月收治的气虚痰浊型老年难治性高血压患者140例,按随机数字表法将其分为治疗组(n=70)和对照组(n=70)。两组均采用缬沙坦胶囊+比索洛尔片+硝苯地平控释片+氢氯噻嗪片的西药标准治疗,在此基础上,治疗组加用益气化痰的中药汤剂联合针刺+耳穴贴压治疗,两组均连续治疗24周。比较两组的疗效;比较两组治疗前和治疗24周的血浆立位肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)水平;比较两组治疗前和治疗12、24周的诊室血压;比较两组的不良反应发生情况。结果:治疗组的总有效率为92.86%,高于对照组的74.29%,差异有统计学意义(χ^2=8.792,P=0.003)。治疗24周,两组的血浆立位PRA、AngⅡ及ALD水平均低于治疗前,且治疗组的立位AngⅡ及ALD水平均低于对照组,差异均有统计学意义(P<0.05)。治疗12、24周,两组的收缩压均低于治疗前,且治疗组均低于对照组,差异均有统计学意义(P<0.05);治疗12周,治疗组的舒张压低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(χ^2=0.431,P=0.512)。结论:在西药标准治疗的基础上,加用益气化痰法治疗气虚痰浊型老年难治性高血压,血压水平控制良好,对肾素血管紧张素系统有更为积极的影响,且不增加不良反应发生率。
Objective:To investigate the clinical effect of yiqi huatan method in the treatment of senile refractory hypertension.Method:A total of 140 elderly patients with refractory hypertension as qixu tanzhuo type admitted to Guangdong Provincial People’s Hospital from January 2019 to January 2020 were selected,they were divided into treatment group (n=70) and control group (n=70) by random number table method.Both groups received standard western medicine treatment of Valsartan Capsules + Bisoprolol Tablets + Nifedipine Controlled-release Tablets + Hydrochlorothiazide Tablets,on this basis,the treatment group was treated with traditional Chinese medicine decoction for yiqi huatan combined with acupuncture + auricular point sticking,and both groups were treated for 24 weeks continuously.The efficacy of the two groups was compared;the plasma stand renin activity (PRA) and angiotensin Ⅱ (AngⅡ),aldosterone (ALD) levels of the two groups before treatment and treatment of 24 weeks were compared;the blood pressure of the two groups was compared before treatment and 12 and 24 weeks after treatment;the occurrence of adverse reactions was compared between the two groups.Result:The total effective rate in the treatment group was 92.86%,higher than 74.29% in the control group,the difference was statistically significant (χ^2=8.792,P=0.003).At 24 weeks of treatment,plasma stand PRA,AngⅡ and ALD levels of two groups were lower than those before the treatment,and the stand AngⅡ and ALD levels of the treatment group were lower than those of the control group,the differences were statistically significant (P<0.05).At 12 and 24 weeks of treatment,the systolic blood pressure in both groups were lower than those before treatment,and those in the treatment group were lower than those in the control group,the differences were statistically significant (P<0.05);after 12 weeks of treatment,diastolic blood pressure in the treatment group was significantly lower than that in the control group (P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups (χ^2=0.431,P=0.512).Conclusion:On the basis of the standard treatment of western medicine,combined with yiqi huatan method to treat the aged refractory hypertension with qixu tanzhuo,the blood pressure level is well controlled,and the renin angiotensin system has a more positive effect,without increasing the incidence of adverse reactions.
作者
吴樱
付婷婷
梁天山
WU Ying;FU Tingting;LIANG Tianshan(Guangdong Provincial People’s Hospital(Guangdong Academy of Medical Sciences),Guangzhou 510080,China;不详)
出处
《中国医学创新》
CAS
2020年第32期75-79,共5页
Medical Innovation of China
基金
广东省中医药局科研项目(20191012)。
