摘要
目的观察川芎天麻汤联合替米沙坦治疗老年非杓型高血压伴左心室舒张功能不全的临床疗效。方法选取2018年1月—2019年6月期间于东营市人民医院就诊的老年非杓型高血压伴左心室舒张功能不全患者80例,将入选患者随机分为对照组和观察组,每组各40例。对照组接受替米沙坦治疗,观察组在对照组基础上加用川芎天麻汤治疗。治疗12周后,观察记录两组患者治疗前后24 h动态血压监测(ABPM)参数、夜间血压下降率、血压晨峰现象、超声心动图检查指标变化情况及临床疗效。结果治疗后观察组总有效率为92.50%(37/40)与对照组72.50%(29/40)比较,差异有统计学意义(P<0.05)。两组患者治疗后中医症状积分、ABPM参数(nMDBP、nMSBP、24 h MDBP、24 h MSBP、dMDBP、dMSBP)、血压晨峰值、血压晨峰检出率均较治疗前降低,差异有统计学意义(P<0.05);且观察组均较对照组明显降低,差异有统计学意义(P<0.05)。两组患者治疗后夜间SBP、DBP下降率均较治疗前明显升高,差异有统计学意义(P<0.05);且观察组夜间SBP、DBP下降率均较对照组明显升高,差异有统计学意义(P<0.05)。治疗后观察组血压昼夜节律恢复为杓型血压比率为70.00%(28/40),明显高于对照组55.00%(22/40),差异有统计学意义(P<0.05)。两组患者治疗后Tei指数和E/e′均较治疗前明显降低,E/A、e′均较治疗前明显升高,差异有统计学意义(P<0.05),LVEF无明显变化,差异无统计学意义(P>0.05);且观察组E/A、e′、E/e′、Tei指数改善情况均优于对照组,两组比较,差异有统计学意义(P<0.05)。结论川芎天麻汤联合替米沙坦不仅可改善老年非杓型高血压患者血压昼夜节律,降压平稳,且能降低血压晨峰现象发生率,改善左心室舒张功能。
Objective To observe the clinical effect of Chuanxiong Tianma decoction combined with telmisartan in the treatment of elderly non-dipper hypertension with left ventricular diastolic dysfunction.Methods 80 elderly patients with non-dipper hypertension and left ventricular diastolic dysfunction who were treated in Dongying People′s Hospital from January 2018 to June 2019 were selected,and the selected patients were randomly divided into control group and observation group.40 cases.The control group received telmisartan treatment,and the observation group was additionally treated with Chuanxiong Tianma Decoction on the basis of the control group.After 12 weeks of treatment,24 h ambulatory blood pressure monitoring(ABPM)parameters,nocturnal blood pressure drop rate,morning blood pressure peak phenomenon,echocardiographic index changes and clinical efficacy were observed and recorded in the two groups before and after treatment.Results After treatment,the total effective rate in the observation group was 92.50%(37/40)compared with 72.50%(29/40)in the control group,and the difference was statistically significant(P<0.05).After treatment,TCM symptom scores,ABPM parameters(nMDBP,nMSBP,24 h MDBP,24 h MSBP,dMDBP,dMSBP),morning peak blood pressure,and detection rate of morning blood pressure in the two groups were all lower than those before treatment,and the difference was statistically significant(P<0.05);and the observation group was significantly lower than the control group,and the difference was statistically significant(P<0.05).The nighttime SBP and DBP decline rates of the two groups of patients after treatment were significantly higher than those before treatment,and the difference was statistically significant(P<0.05).Academic significance(P<0.05).After treatment,the circadian rhythm of blood pressure in the observation group returned to dipper blood pressure was 70.00%(28/40),which was significantly higher than that in the control group,55.00%(22/40),with a statistically significant difference(P<0.05).After tre
作者
冯涛
王红光
刘子亮
FENG Tao;WANG Hong-guang;LIU Zi-liang(Dongying People′s Hospital,Dongying Shandong 257091)
出处
《世界中西医结合杂志》
2022年第2期375-379,383,共6页
World Journal of Integrated Traditional and Western Medicine
基金
山东省医药卫生科技发展计划(2019WS040)。
关键词
川芎天麻汤
替米沙坦
血压昼夜节律
老年非杓型高血压
左心室舒张功能不全
Chuanxiong Tianma Decoction
Telmisartan
Circadian Rhythm of Blood Pressure
Non-Dipper Hypertension
Left Ventricular Diastolic Dysfunction
