社区复方制剂抗高血压治疗研究:2年干预效果分析

摘要

目的: 观察复方利血平氨苯喋啶片(北京降压0号)和复方利血平片(复方降压片)长期治疗轻、中度高血压的效果、安全性和依从性.方法: 选取2008-10至2009-01 北京7个农村社区的轻、中度原发性高血压患者766例,年龄45~75岁,随机分成2组,分别服用北京降压0号(降压0号组,393例)和复方降压片(复降片组,373例),北京降压0号的剂量为0.5~1片/次,1次/d,复方降压片的剂量为1~2片/次,3次/d,观察时间为24个月.结果:共710例患者完成试验,降压0号组与复降片组患者收缩压/舒张压下降幅度[(24.7±13.9/13.2±8.8)mmHg vs(23.0±14.2/11.9±9.5)mm Hg,1 mmHg=0.133 kPa]、总有效率(89.0% vs 84.5%)、不良反应发生率(0.5% vs 1.34%)差异均无统计学意义(P>0.05).对于2级高血压患者,服药后1、6、12、24个月降压0号组舒张压的下降幅度均高于复降片组,差异有统计学意义(P<0.05);降压0号组患者在服药24个月末依从性高于复降片组[(99.2±4.8)% vs (98.2±6.5)% ],差异有统计学意义 (P<0.05).结论:北京降压0号依从性和对2级高血压的降压幅度高于复方降压片.两组不良反应差异不明显,均未见明显的不良作用.%Objective: To observe the long term effect, safety and compliance of antihypertensive compound (AC) and reserpine compound (RC) for treating the patients with mild to moderate essential hypertension (EH) in community health care management. Methods: A total of 766 patients with mild to moderate EH were enrolled from 7 rural communities of Beijing from 2008-10 to 2009-01. The patients were from (45-75) years of age and assigned into 2 groups: AC group, the patients took AC from (0.5-1.0) tablet/day,n=393 and RC group, the patients took RC from (1-2) tablets/time for 3 times/day,n=373; all patients were treated for 24 months. The general conditions were compared between 2 groups of patients. Results: There were 710 patients finished the following-up study. The reduction of blood pressure (BP) by AC and RC were (24.7 ± 13.9) mmHg /(13.2 ± 8.8) mmHg vs (23.0 ± 14.2) mmHg/(11.9 ± 9.5) mmHg respectively, thetotal effective rate was 89.0% vs 84.5%, and the occurrence rate of adverse events was 0.5% vs 1.34%, all P >0.05.For patients with grade 2 hypertension, the reduction of diastolic BP in AC group was higher than RC group with 1, 6,12 and 24 months treatment, P <0.05. AC group had better medical compliance than RC group (99.2 ± 4.8) % vs (98.2± 6.5) % with 24 months medication, P <0.05.Conclusion: The medical compliance and reduction of grade 2 EH of AC were higher than RC for 24 monthstreatment. There were no obvious adverse events for AC or RC treatment.