平肝通脉方对高血压病肝阳上亢夹血瘀证病人中医证候及颈动脉IMT的影响

摘要

目的：观察平肝通脉方对高血压病肝阳上亢夹血瘀证病人中医证候及颈动脉内膜中层厚度的影响。方法将82例高血压病肝阳上亢夹血瘀证病人随机分为治疗组(42例)和对照组(40例)。治疗组口服中药平肝通脉方和苯磺酸氨氯地平片，对照组口服苯磺酸氨氯地平片，服药24周时观察两组降压疗效、中医证候疗效及治疗前后颈动脉内膜中层厚度的变化。结果治疗组降压显效率为61.90%，总有效率为92.86%，对照组降压显效率为40.00%，总有效率为82.50%，两组总有效率比较差异无统计学意义，但两组显效率比较差异有统计学意义(P<0.05)。治疗组中医证候总有效率为92.86%，对照组为67.50%，两组比较有统计学意义(P<0.01)。治疗后两组颈动脉内膜中层厚度均降低(P<0.05或P<0.01)，两组治疗前后差值比较有统计学意义，治疗组优于对照组(P<0.05)。治疗组和对照组的不良反应发生率分别为7.14%和10.00%，两组比较差异无统计学意义。结论平肝通脉方对高血压病肝阳上亢夹血瘀证病人有较好的临床疗效，且能降低病人的颈动脉内膜中层厚度。%Objective To explore the effects of Pinggan Tongmai formula(PTF)on traditional Chinese medicine (TCM)syndrome and carotid artery intima media thickness (IMT)in patients with essential hypertension(EH)with liver yang hyperactivity and blood stasis syndrome.Methods Eighty two patients with EH and liver yang hyperactivity and blood stasis syndrome were randomly di-vided into two groups:control group (n=40)treated with amlodipine besylate tablets and treatment group (n=42)treated with PTF and amlodipine besylate tablets for 24 weeks.The antihypertensive efficacy and the safety were evaluated,and the changes of carotid artery IMT and TCM syndrome were observed in two groups before and after treatment.Results In antihypertensive efficacy,the markedly effective rate and total effective rate in treatment group were 61.90% and 92.86%,those were 40.00% and 82.50% in con-trol group.There was no significant difference of the total effective rate between two groups,but the difference of the markedly effec-tive rate between the two groups had statistical significance.Efficiency of TCM syndrome in the treatment group was 92.86%,com-pared with the control group (67.50%),there was significant difference.The carotid artery IMT decreased significantly in both groups after treatment,the change amount before and after treatment was significant difference between two groups.The incidence of side effect was 7.14% in treatment group and 10.00% in control group,there was no significant differences between two groups.Conclu-sion PTF has better therapeutic effect in essential hypertension patients with liver yang hyperactivity and blood stasis syndrome, and maybe effectively decrease hypertensive carotid artery intima media thickness.