摘要:
目的 探讨中药夏枯草汤联合苯磺酸氨氯地平对老年高血压患者临床疗效及血浆内皮素-1 (ET-1)的影响.方法 选择2016年1月至2018年1月温岭市中医院收治的老年高血压患者76例,根据治疗方法不同分为对照组38例和观察组38例.对照组采用钙离子拮抗剂苯磺酸氨氯地平片治疗,观察组采用中西医结合疗法(夏枯草汤联合苯磺酸氨氯地平片)治疗,两组均治疗2个月,评估治疗效果.以24 h平均舒张压(24 hDBP)、24 h平均收缩压(24 hSBP)、白昼舒张压(dDBP)、白昼收缩压(dSBP)、夜间舒张压(nDBP)和夜间收缩压(nSBP)评价临床疗效;以治疗前、后ET-1水平评价对血管内皮功能的影响,比较两组临床疗效及对ET-1的影响.结果 观察组治疗后24 hDBP(72.26 ±4.62)mmHg、24 hSBP(133.26 ±6.71)mmHg、dDBP (76.08 ±5.26)mmHg、dSBP(136.51 ±8.63)mmHg、nDBP(72.34 ±3.96)mmHg和nSBP(133.64 ±5.21)mmHg水平,均低于对照组 24 hDBP ( 86.63 ±5.18 ) mmHg、24 hSBP ( 143.29 ±7.22 ) mmHg、 dDBP ( 87.32 ± 5.73)mmHg、dSBP(153.67 ±9.51)mmHg、nDBP(80.75 ±4.27)mmHg和nSBP(148.27 ±6.32)mmHg水平(t=12.637、11.268、11.762、12.406、10.625、11.738,均 P <0.05);观察组治疗后血浆ET-1 水平为(59.37 ± 7.82)μg/L,低于对照组的(67.58 ±7.72)μg/L(t=10.653,P<0.05).结论 老年人高血压采用中药夏枯草汤联合苯磺酸氨氯地平治疗,能有效提升治疗效果,降低其血压水平,并能够改善血管内皮功能,值得推广应用.%Objective To study the clinical curative effect of Chinese traditional medicine Prunella vulgaris Decoction for elderly hypertensive patients ,and its influence on endothelin -1( ET -1).Methods From January 2016 to January 2018,76 senile patients with hypertension in Wenling Hospital of Traditional Chinese Medicine were selected.According to different therapeutic methods ,the patients were divided into two groups ,with 38 cases in each group.The control group was given calcium antagonists benzene sulfonic acid amlodipine therapy , the observation group was given the combined therapy of Chinese and western medicine ( Prunella vulgaris Decoction combined with benzene sulfonic acid amlodipine ).All the patients were treated for 2 months,the therapeutic effect was evaluated . The 24-hour average diastolic blood pressure (24hDBP),24-hour average systolic blood pressure (24hSBP),and diastolic pressure (dDBP),the day systolic blood pressure (dSBP),diastolic blood pressure at night (nDBP) and nocturnal systolic blood pressure (nSBP) were used to evaluate the clinical curative effect .Before and after treatment, the plasma ET-1 level was used to evaluate the influence on endothelial function .The clinical curative effect and its influence on ET-1 were compared between the two groups .Results After treatment,the 24hDBP,24hSBP,dDBP, dSBP,nDBP and nSBP in the observation group were significantly lower than those in the control group [24hDBP (72.26 ±4.62)mmHg vs.(86.63 ±5.18) mmHg,24hSBP (133.26 ±6.71) mmHg vs.(143.29 ±7.22) mmHg, dDBP (76.08 ±5.26)mmHg vs.(87.32 ±5.73)mmHg,dSBP (136.51 ±8.63)mmHg vs.(153.67 ±9.51)mmHg,nDBP (72.34 ±3.96)mmHg vs.(80.75 ±4.27)mmHg,nSBP (133.64 ±5.21)mmHg vs.(148.27 ±6.32)mmHg,t=12.637,11.268,11.762,12.406,10.625,11.738,all P<0.05].The plasma ET-1 level of the observation group was (59.37 ±7.82)μg/L,which was significantly lower than (67.58 ±7.72)μg/L of the control group (t =10.653,P<0.05).Conclusion Prunella vulgaris Decoction in the treatment of elderly hypertensive patients can effectively improve therapeutic effect , lower the blood pressure levels , and can improve endothelial function , it is worthy of popularization and application .