三物降压汤、通经调脏法推拿联合对眩晕合并高血压患者控压效果的影响

摘要

目的 探析三物降压汤、通经调脏法推拿联合对眩晕合并高血压患者控压效果的影响.方法 选取眩晕合并高血压患者300例作为研究对象,按照随机数字表进行编号,奇数号纳入观察组(n=153)、偶数号纳入对照组(n=147).对照组应用苯磺酸氨氯地平片和(或)厄贝沙坦片进行治疗,观察组在对照组基础上联合三物降压汤、通经调脏法推拿治疗.比较两组治疗前后收缩压(SBP)、舒张压(DBP)、血浆内皮素(ET)、一氧化氮(NO)差异,记录眩晕证候总有效率,另分组记录两组生活质量、不良反应发生率.结果 观察组眩晕证候总有效为91.5％,高于对照组82.3％,差异有统计学意义(P<0.05).两组治疗前SBP、DBP、ET、NO、生活质量各项评分的差异无统计学意义(P>0.05);治疗后两组SBP、DBP、ET、生活质量各项评分均降低、NO升高(P<0.05),观察组治疗后的SBP、DBP、ET分别降低至(118.7±7.9)mmHg、(78.3±5.2)mmHg、(50.4±6.1)pg·L-1,低于对照组(P<0.05),生活质量各项评分也低于对照组(P<0.05);NO为(171.4±16.0)μmol·L-1,高于对照组(P<0.05).结论 三物降压汤可有效清肝降火、降脂降压,通经调脏法推拿则可通经调脏改善血管内皮活性,调节ET与NO的合成与释放,控压效果良好,眩晕症状改善明显.%Objective To explore the effect of sanwu hypotensive decoction combined with menstrual flow-stimulating and liver-regula-ting massage on pressure control in patients with vertigo complicated with hypertension. Methods A total of 300 patients with vertigo complicated with hypertension treated in Hubei Provincial Hospital of TCM from June 2012 to December 2015 were randomized into ob-servation group (n=153) and control group (n=147). The control group was treated with amlodipine besylate tablets and/or irbesar-tan tablets while the observation group,based on the treatment in control group,was treated with sanwu hypotensive decoction combined with menstrual flow-stimulating and liver-regulating massage. The systolic blood pressure( SBP) ,diastolic blood pressure( DBP) ,plasma endothelin(ET) and nitric oxide(NO) were compared between the two groups before and after treatment. The total response rate of ver-tigo syndrome,quality of life and incidence of adverse reactions in the two groups were recorded. Results The total response rate in ob-servation group(91. 5％) was significantly higher than that in control group(82. 3％)(P<0. 05). There were no significant differences in SBP,DBP,ET,NO and quality of life scores between the two groups before treatment(P>0. 05). After treatment,SBP,DBP,ET and quality of life scores in the two groups decreased while NO increased(P<0. 05). After treatment,SBP,DBP and ET in observation group were decreased to (118.7 ±7.9) mmHg,(78.3 ±5.2) mmHg and (50.4 ±6.1) pg·L-1,respectively,lower than those in control group (P<0. 05). Quality of life was also lower than that of control group (P<0. 05) while NO(171. 4 ± 16. 0) μmol·L-1 was higher than that in control group (P<0. 05). Conclusions Sanwu hypotensive decoction can effectively remove heat from the liv-er,lower blood lipid and blood pressure. Menstrual flow-stimulating and liver-regulating massage can improve endothelial activity and regulate the synthesis and release of ET and NO. The pressure control effect is good,and vertigo symptoms can be improved significantly.