加味黄连温胆汤治疗H型高血压痰瘀互结证患者临床疗效及对LVMI的影响

Effect of modified Huanglian Wendan Decoction on clinical efficacy and LVMI in H-type hypertension patients with the syndrome of phlegm blended with blood stasis

关键词:  H型高血压  左心室质量指数  黄连温胆汤  痰瘀互结证

Key words:  H-type hypertension  left ventricular mass index  Huanglian Wendan Decoction  syndrome of phlegm blended with blood stasis

摘要:

[目的] 观察加味黄连温胆汤对H型痰瘀互结证高血压患者的临床疗效以及对该类患者左心室质量指数的影响。[方法] 将入选的70例符合诊断标准的H型高血压患者随机分成对照组（西药常规治疗）35例和治疗组（常规治疗结合加味黄连温胆汤）35例，两组患者的治疗周期均为8周。观察治疗前后症状改善程度、血压水平、血同型半胱氨酸（Hcy）、血脂以及左心室质量指数（LVMI）的变化。[结果] 治疗组中医证候疗效总有效率为94.29%，对照组为71.43%，治疗组高于对照组（P<0.05）；血压疗效方面，治疗组有效率为94.3%，对照组为77.1%，治疗组优于对照组（P<0.05）；治疗后两组患者三酰甘油、总胆固醇、低密度脂蛋白胆固醇都降低，高密度脂蛋白胆固醇水平都增加（P<0.01），且治疗组效果更显著（P<0.05）；在LVMI方面，治疗组与对照组均较治疗前有所下降（P<0.01），但治疗组下降更明显（P<0.05）；血Hcy水平治疗组优与对照组（P<0.05）。治疗过程中，两组患者均未出现不良反应。[结论] 与单纯西药治疗相比，联合加味黄连温胆汤能够改善H型高血压痰瘀互结证患者的临床症状并降低其LVMI，且安全性良好。

Abstract:

[Objective] To observe the clinical effect and the left ventricular mass index(LVMI) in H-type hypertension patients with the syndrome of phlegm blended with blood stasis treated by modified Huanglian Wendan Decoction.[Methods] A total of 70 patients who met the diagnostic criteria of H-type hypertension were enrolled and randomly divided into the control group (conventional Western medicine treatment) and treatment group (conventional Western medicine treatment combined with modified Huanglian Wendan Decoction),with 35 cases in each group. The course of treatment was 8 weeks in both two groups. The degree of symptom improvement,the level of blood pressure,homocysteine(Hcy),blood lipid,and left ventricular mass index were compared between the two groups of patients before and after treatment.[Results] The total effective rate of traditional Chinese medicine syndromes in the treatment group was 94.29%,which was higher than 71.43% in the control group(P<0.05). The total effective rate of hypertension in the treatment group was 94.3%,which was higher than 77.1% in the control group(P<0.05). After treatment,the triacylglycerol,total cholesterol,and low density lipoprotein cholesterol of the two groups of patients decreased,and high density lipoprotein cholesterol increased(P<0.01),which was more significant in the treatment group(P<0.05). The LVMI of the two groups of patients after treatment was lower than that before treatment (P<0.01),and the LVMI of patients in the treatment group was lower than that of the control group (P<0.05). The serum Hcy level of patients in the treatment group was higher than that of the control group(P<0.05). The two groups of patients showed no obvious adverse reaction during treatment.[Conclusion] Compared with simple Western medicine,Western medicine combined with modified Huanglian Wendan Decoction in the treatment of H-type hypertension patients with the syndrome of phlegm blended with blood stasis can improve the clinical symptoms and reduce the LVMI safaely