辨证分型联合氯沙坦治疗老年高血压合并左心室肥厚随机平行对照研究被引量：1

Syndrome Differentiation and Type Differentiation Combined with Losartan in Treatment of Senile Hypertension Complicated with Left Ventricular Hypertrophy: A Randomized Parallel Controlled Study

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摘要 [目的]观察辨证分型联合氯沙坦治疗老年高血压合并左心室肥厚疗效。[方法]使用随机平行对照方法,将144例门诊患者按就诊顺序号随机分为两组。对照组72例氯沙坦,50mg/次,1次/d,根据血压调整剂量。治疗组72例辨证分型治疗,肝火亢盛-杞菊地黄汤(枸杞、桑寄生、菊花、熟地黄、山茱萸、山药各9g,女贞子、赤芍、石斛各6g,鳖甲10g,牛膝、杜仲、牡蛎、珍珠母,钩藤、麦冬各5g);阴阳两虚-肾气丸(熟地黄24g,山萸肉、山药各12g、杜仲、肉桂3g,丹皮、茯苓各9g,牛膝、牡蛎、黄芪、酸枣仁各6g,附子3g);痰湿壅盛-半夏白术天麻汤(半夏9g,白术18g,天麻、钩藤、橘红、茯苓各6g,甘草、生姜、大枣、远志各5g),水煎400mL,早晚温服;氯沙坦治疗同对照组。连续治疗6个月为1疗程。观测临床表现、舒张压、收缩压、左心室舒张末期内径、室间隔舒张末期厚度、左室后壁舒张末期厚度、不良反应。治疗1疗程(6个月),判定疗效。[结果]治疗组显效42例,有效27例,无效3例,总有效率95. 83%;对照组显效35例,有效26例,无效11例,总有效率84. 72%;治疗组疗效优于对照组(P <0. 05)。DBP、SBP、LVEDD、IVST、LVPWT两组均有改善(P <0. 05,P <0. 01),治疗组改善优于对照组(P <0. 01)。[结论]辨证分型联合氯沙坦治疗老年高血压合并左心室肥,疗效满意,无严重不良反应,值得推广。 [Objective]To observe the curative effect of combination of syndrome differentiation and typing and losartan in the treatment of senile hypertension complicated with left ventricular hypertrophy.[Method]A total of 142 outpatients were randomly divided into two groups according to the order of visiting. In the control group,72 cases were given losartan,50 mg/time,once a day,regulating the dose according to blood pressure. In the treatment group,72 cases according to the syndrome differentiation and typing,were treated with Ganhuo KangshengQiju Dihuang Decoction[Gouqi( Barbary Wolfberry Fruit) 9 g,Sangjisheng( Chinese Taxillus Herb) 9 g,Shudihuang( Prepared Rehmannia Root) 9 g,Shanzhuyu( Asiatic Cornelian Cherry Fruit) 9 g,Shanyao( Common Yam Rhizome) 9 g,Nuzhenzi( Glossy Privet Fruit) 6 g,Chishao( Red Peony Root) 6 g,Shihu( Dendrobium nobile) 6 g,Biejia( Turtle Carapace) 10 g,Niuxi( Achyranthes bidentata) 5 g,Duzhong( Eucommia Bark) 5 g,Muli( Oyster Shell) 5 g,Zhenzhumu( Nacre) 5 g,Gouteng( Gambir Plant Nod) 5 g,Maidong( Dwarf Lilyturf Tuber) 5 g〗,Yinyang LiangxuShenqi Pills[Shudihuang( Prepared Rehmannia Root) 24 g,Shanyurou( Asiatic Cornelian Cherry Fruit) 12 g,Shanyao( Common Yam Rhizome) 12 g,Duzhong( Eucommia Bark) 3 g,Rougui( Cassia Bark) 3 g,Danpi( Peony Root Bark) 9 g,Fuling( Poria) 9 g,Niuxi( Achyranthes bidentata) 6 g,Muli( Oyster Shell) 6 g,Huangqi( Milkvetch Root) 6 g,Suanzaoren( Spine Date Seed) 6 g,Fuzi( Aconitum) 3 g],Tanshi YongshengBanxia Baizhu Tianma Decoction[Banxia( Pinellia Tuber) 9 g,Baizhu( White Atractylodes Rhizome) 18 g,Tianma( Tall Gastrodia Tuber) 6 g,Gouteng( Gambir Plant Nod) 6 g,Juhong( Pummelo Peel) 6 g,Fuling( Poria) 6 g,Gancao( Liquorice Root) 5 g,Shengjiang( ginger) 5 g,Dazao( Chinese Date) 5 g,Yuanzhi( Milkwort Root) 5 g \],400 m L for decocting,taking in the morning and evening. The Losartan treatment was the same as that of the control group. Continuous 6 months was a course of treatment. Clinical manifestations,diastolic blood pressure,systolic blood pressure,left ventricu

作者容燕虹黎建华罗兴李天舒 RO NG Yanhong;LI Jianhua;Luoxing;LI Tianshu(Guicheng Street Community Health Service Center,Foshan 528251 ,Guangdong,China)

机构地区佛山市南海区桂城街道社区卫生服务中心

出处《实用中医内科杂志》 2019年第6期5-9,共5页 Journal of Practical Traditional Chinese Internal Medicine

关键词高血压左心室肥厚肝火亢盛阴阳两虚痰湿壅盛杞菊地黄汤肾气丸半夏白术天麻汤氯沙坦舒张压收缩压左心室舒张末期内径室间隔舒张末期厚度左室后壁舒张末期厚度中药复方随机平行对照研究 hypertension left ventricular hypertrophy liver-fire hyperactivity Yin-Yang deficiency phlegm-dampness congestion Qiju Dihuang Decoction Shenqi Pill Banxia Baizhu Tianma Decoction losartan diastolic blood pressure systolic blood pressure left ventricular end-diastolic internal menstruation interventricular septal end-diastolic thickness left ventricular posterior wall end-diastolic thickness Chinese medicine compound prescription randomized parallel controlled study