复方丹参滴丸对非勺型高血压患者血压昼夜节律及高敏C反应蛋白、心功能的影响

摘要

Objective To investigate the influences of Compound Danshen Gutta Pills (taking for a long time) on circadian rhythm of blood pressure (BP), high-sensitivity C-reactive protein (hs-CRP) and heart function in patients with non-dipper hypertension. Methods The patients (n=178, male 92, female 86 and aged from 45 to 76) were chosen from Jan. 2009 to Jan. 2013. All patients were divided into treatment group (n=88) and control group (n=90) according to random digits table, and treated with levoamlodipine maleate (2.5 mg) once a day. Those whose BP was still higher than 140/90 mmHg (1 mmHg=0.133kPa)were given valsartan. The treatment group was additionally given Compound Danshen Gutta Pills (10 pills for 3 times a day) for 6 m. The changes of BP were monitored dynamically, circadian rhythm of BP was observed, effective rate of changes of BP circadian rhythm was calculated, hs-CRP was detected and heart function was monitored by using echocardiogram. Results All BP indexes were improved in 2 groups after treatment (all P<0.01). After treatment, nighttime systolic blood pressure (SBP), nighttime diastolic blood pressure (DBP), nighttime BP loading and daytime BP loading all decreased in treatment group compared with control group (all P<0.05). The effective rate of changes of SBP or DBP circadian rhythm were significantly improved in treatment group compared with control group after treatment (41.01%vs. 78.38%, 42.11%vs. 75.00%, all P<0.05). The level of hs-CRP decreased and E/A increased in treatment group after treatment (all P<0.05). The level of hs-CRP decreased in treatment group compared with control group after treatment [(1.85±0.93) mg/L vs. (0.86±0.71) mg/L, P<0.01]. There were no adverse reactions as rash and stomachach observed in 2 groups. Conclusion Compound Danshen Gutta Pills (taking for a long time) can ameliorate circadian rhythm of BP, reduce hs-CRP level and improve cardiac diastolic function in patients with non-dipper hypertension.%目的：探讨长期服用复方丹参滴丸对非勺型高血压患者血压昼夜节律及高敏C反应蛋白（hs-CRP）、心功能的影响。方法选取自2009年1月至2013年1月于株洲市331医院高血压研究所就诊的高血压患者178例，其中男性92例，女性86例，年龄范围45~76岁。随机分为治疗组（88例）和对照组（90例）。所有患者均给予马来酸左旋氨氯地平2.5 mg，1/日，血压＞140/90 mmHg（1 mmHg=0.133kPa），加用缬沙坦。治疗组加服复方丹参滴丸10粒，3/日，连续服用6个月。24 h动态监测血压，观察昼夜节律并计算昼夜节律改变的有效率，检测hs-CRP，超声心动图检测心功能。结果治疗组和对照组治疗后较治疗前各血压指标均改善，差异有显著统计学意义（P均＜0.01）。与对照组治疗后比较，治疗组夜间收缩压、夜间舒张压以及夜间血压负荷和白昼血压负荷均下降，差异有统计学意义（P均＜0.05）。与对照组比较，治疗组治疗后收缩压和舒张压昼夜节律变化有效率均明显改善，分别为41.01%vs.78.38%，42.11%vs.75.00%，差异有统计学意义（P均＜0.05）。治疗组治疗后较治疗前hs-CRP降低，E/A升高，差异有统计学意义（P均＜0.05）。与对照组治疗后比较，治疗组hs-CRP降低[（1.85±0.93）mg/L vs.（0.86±0.71）mg/L]，差异有显著统计学意义（P＜0.01）。两组均未见皮疹、胃痛等不良反应。结论长期服用复方丹参滴丸能改善非勺型高血压患者血压昼夜节律，降低hs-CRP水平，改善心脏舒张功能。