运用广义估计方程评估松龄血脉康胶囊对原发性高血压不同血压分级的疗效

摘要

目的 运用广义估计方程评估松龄血脉康胶囊对原发性高血压不同血压分级的疗效.方法 采用真实世界研究的方法,纳入2 974例应用松龄血脉康胶囊的原发性高血压病人,根据是否合并西药降压药,分为中药组(单纯使用松龄血脉康胶囊)1 544例和联合组(松龄血脉康胶囊联用西药降压药)1 430例,疗程8周,每2周随访一次.根据重复测量数据间具有相关性的特点,在考虑混杂因素情况下,建立广义估计方程模型(GEE),比较收缩压(SBP)和舒张压(DBP)在不同时点、不同组别、不同血压分级之间的疗效差异.结果 1级高血压SBP,中药组与联合组在不同时点降压效果相当(P>0.05);1级高血压DBP,中药组与联合组在治疗2周、4周、6周降压效果相当(P>0.05),治疗8周时,联合组的降压效果优于中药组(P<0.001).2级高血压SBP组在不同时点的降压效果优于中药组(P<0.001);2级高血压DBP,中药组与联合组在不同时点降压效果相当(P>0.05).3级高血压SBP、DBP,联合组在不同时点降压效果优于中药组(P<0.001).2级高血压SBP组在不同时点的降压效果优于中药组(P<0.001);2级高血压DBP,中药组与联合组在不同时点降压效果相当(P>0.05).3级高血压SBP、DBP,联合组在不同时点降压效果优于中药组(P<0.001).结论 松龄血脉康胶囊在2级、3级高血压舒张压降压方面具有一定的优势.%Objective To evaluate the effect of Songling Xuemaikang capsule (SXC) on different blood pressure grades of essential hypertension (EH) by generalized estimation equation (GEE).Methods Real-world study method was used,and 2 974 patients with EH taking SXC were included.According to the use of western medicine (WM) antihypertensive drugs or not, patients were divided into SXC group (n=1 544), combined group (n=1 430, SXC plus WM antihypertensive drugs) for the treatment of 8 weeks and followed up every 2 weeks.Bsaed on correlation among repeated measures and to establish GEE in consideration the confounder to compare the efficacy of systolic blood pressure (SBP) and diastolic blood pressure (DBP) between different time points, groups and blood pressure grades.Results The efficacy in patients with grade 1 of SBP in SXC group was similar to combined group (P>0.05).The efficacy in patients with grade 1 of DBP in SXC group was similar to combined group after 2, 4 and 6 weeks of treatment (P>0.05).The efficacy in combined group was better than that in SXC group after 8 weeks (P<0.001).The efficacy in patients with grade 2 of SBP in combined group was better than that in SXC group at different time points (P<0.001).The efficacy in patients with grade 2 of DBP in SXC group was similar to combined group at different time points (P>0.05).The efficacy in patients with grade 3 of SBP and DBP in combined group was better than that in SXC group at different time points (P<0.001).Conclusion SXC has the advantage on lowering DBP with grade 2 and 3 in patients with EH.