摘要
目的观察升清降浊方联合小剂量盐酸米多君片治疗帕金森病直立性低血压(PD-OH)合并卧位高血压(SH)气虚痰瘀证的临床疗效。方法采用随机数字表法将110例患者分为观察组、对照组各55例。2组均予盐酸米多君片,2.5 mg/次,2次/d(晨起前、午餐后),口服;观察组在此基础上予升清降浊方,每日l剂,100 mL/次,2次/d,口服。2组均采用非药物疗法干预SH。若试验过程中SH进一步加重且经评估需药物治疗,予氯沙坦钾片睡前口服。2组均连续治疗8周。观察2组中医疗效,监测2组治疗前后起立前即刻卧位血压和直立3 min时立位血压,比较2组治疗前后中医证候积分、直立性低血压自评量表(OHQ)评分。采用不良反应量表(TESS)监测2组安全性评价指标。结果观察组脱落3例,对照组脱落1例。观察组总有效率为76.92%(40/52),对照组为46.30%(25/54),观察组中医疗效优于对照组(P<0.05)。与本组治疗前比较,2组治疗后立位收缩压、舒张压均明显升高(P<0.05),观察组治疗后卧位收缩压、舒张压均无显著波动(P>0.05),对照组治疗后卧位收缩压、舒张压均明显升高(P<0.05);2组治疗后比较,观察组立位收缩压、舒张压均优于对照组(P<0.05)。2组试验期间均未加用氯沙坦钾片。与本组治疗前比较,2组治疗后中医证候积分、OHQ评分均下降(P<0.05);2组治疗后比较,观察组中医证候积分、OHQ评分均低于对照组(P<0.05);观察组治疗前后中医证候积分、OHQ评分差值均优于对照组(P<0.05)。2组不良反应以口干、出汗为主,可自行缓解,均未干预。2组TESS各项评分比较差异均无统计学意义(P>0.05)。结论升清降浊方联合小剂量盐酸米多君片治疗PD-OH合并SH气虚痰瘀证,可有效减轻患者症状负担,升高立位收缩压、舒张压,较单用盐酸米多君片具有增效作用,同时不影响卧位血压,避免盐酸米多君片所致SH加重。
Objective To observe the clinical efficacy of Shengqing Jiangzhuo Decoction combined with lowdosage midodrine hydrochloride tablets for orthostatic hypotension(OH)combined with supine hypertension(SH)in Parkinson disease(PD)with qi deficiency and phlegm stasis syndrome.Methods Totally 110 patients were divided into observation group and control group by random number table method,with 55 cases in each group.Both groups were given midodrine hydrochloride tablets,2.5 mg/time,twice a day(before morning and after lunch),orally;on this basis,the observation group was given Shengqing Jiangzhuo Decoction,1 dosage per day,100 mL/time,2 times/d,orally.Both groups were treated with non-drug therapy to intervene SH.If the SH further aggravated during the test and it was assessed that drug treatment was required,losartan potassium tablets should be taken before sleep.Both groups were treated continuously for 8 weeks.TCM efficacy of both groups was observed.Blood pressure in lying position immediately before standing up and standing position for 3 mins was monitored.TCM syndrome scores,orthostatic hypotension questionaire(OHQ)scores of the two groups were compared.The safety evaluation indexes of the two groups were monitored by the treatment emergent symptom scale(TESS).Results Three cases in the observation group dropped out,and 1 case in the control group dropped out.The total effective rate was 76.92%(40/52)in the observation group and 46.30%(25/54)in the control group.The observation group was better than the control group(P<0.05).Compared with before treatment,the standing systolic blood pressure and diastolic blood pressure in both groups significantly increased after treatment(P<0.05).After treatment,the supine systolic blood pressure and diastolic blood pressure in the observation group had no significant fluctuations(P>0.05),while the supine systolic blood pressure and diastolic blood pressure in the control group significantly increased after treatment(P<0.05);after treatment,the standing systolic blood pressure an
作者
王倩
黄小波
张春燕
陈玉静
王宏
刘妍
孙亚男
WANG Qian;HUANG Xiaobo;ZHANG Chunyan;CHEN Yujing;WANG Hong;LIU Yan;SUN Yanan(Xuanwu Hospital,Capital Medical University,Beijing Geriatrics Institute of Integrated Traditional Chinese Medicine and Western Medicine,Beijing 100053,China)
出处
《中国中医药信息杂志》
CAS
CSCD
2023年第3期126-131,共6页
Chinese Journal of Information on Traditional Chinese Medicine
基金
国家自然科学基金(81574036)
北京市自然科学基金(7172094)
北京市中医药科技发展资金(JJ-2020-66)。
关键词
升清降浊方
帕金森病
直立性低血压合并卧位高血压
气虚痰瘀证
临床研究
Shengqing Jiangzhuo Decoction
Parkinson disease
orthostatic hypotension combined with supine hypertension
qi deficiency and phlegm stasis syndrome
clinical study
