天麻钩藤饮联合耳部疗法治疗H型高血压病伴失眠的临床疗效观察

Clinical efficacy of Tianma Gouteng Decoction combined with auricular therapy in the treatment of H-type hypertension with insomnia

关键词:  天麻钩藤饮  耳部全息疗法  肝阳上亢  H型高血压病  失眠

Key words:  Tianma Gouteng Decoction  auricular holographic therapy  liver yang hyperactivity  H-type hypertension  insomnia

摘要:

[目的] 本研究采用随机对照试验设计，以评估天麻钩藤饮联合耳部全息疗法对肝阳上亢型H型高血压病合并失眠患者的疗效。[方法] 研究于2022年7月—2024年12月招募来自四川省中西医结合医院武侯老年病门诊及住院部的110例肝阳上亢型H型高血压病伴失眠患者。采用SPSS 26.0软件生成随机序列，并通过不透光信封法进行分配隐藏；患者按就诊顺序抽取信封，按1∶1比例随机分为试验组或对照组，每组各55例。其中对照组采用常规降压、降同型半胱氨酸（Hcy）方案和健康教育，试验组在对照组基础上加用天麻钩藤饮联合耳部全息疗法干预。评估两组患者在临床疗效、血压水平、匹兹堡睡眠质量指数量表（PSQI）评分、同型半胱氨酸及中医证候评分等方面的差异，并记录不良反应。[结果] 试验组的临床总有效率为96.36%，高于对照组的85.45%（χ²=4.725，P=0.014）。治疗后第3、4、12周，两组血压水平较基线显著下降，且试验组降压幅度更大（P<0.05）。两组在治疗后的第3、4、12周PSQI评分低于治疗前，且试验组在治疗后同期PSQI评分低于对照组。与治疗前相比，两组患者的同型半胱氨酸水平均有所下降，且试验组的水平更低，组间差异有统计学意义（P<0.05）。在中医证候评分方面，两组患者治疗后的评分均较治疗前显著降低（P<0.05），试验组下降幅度明显大于对照组（P<0.05）。两组整个研究过程中均无不良反应发生。[结论] 天麻钩藤饮联合耳部全息疗法在改善肝阳上亢型H型高血压病伴失眠患者的症状及相关指标方面具有一定优势，且在治疗过程中安全性较高，可作为临床治疗该类疾病的一种有效方法进一步探索和应用。

Abstract:

[Objective] This randomized controlled trial evaluated the efficacy of Tianma Gouteng Decoction combined with auricular holographic therapy for patients with H-type hypertension（HHT） due to liver yang hyperactivity complicated by insomnia. [Methods] A total of 110 patients with liver yang hyperactivity（HHT） with insomnia were recruited between July 2022 and December 2024 from the geriatric outpatient and inpatient departments of Sichuan Integrative Medicine Hospital. Random sequences were generated using SPSS 26.0 software and concealed using opaque envelopes. Patients were assigned to either the experimental group（n=55） or control group（n=55） in a 1∶1 ratio based on their order of presentation. The control group received conventional antihypertensive therapy，homocysteine（Hcy） reduction protocols，and health education. The experimental group added Tianma Gouteng Decoction combined with auricular holographic intervention to the control group regimen. Differences between groups were assessed for clinical efficacy，blood pressure levels，Pittsburgh Sleep Quality Index（PSQI） scores，homocysteine levels，and traditional Chinese medicine syndrome scores，with adverse reactions recorded. [Results] The overall clinical response rate in the experimental group was 96.36%，significantly higher than the 85.45% in the control group（χ²=4.725，P=0.014）. At weeks 3，4，and 12 post-treatment，blood pressure levels in both groups decreased significantly from baseline，with a greater reduction in the experimental group（P<0.05）. PSQI scores in both groups decreased at weeks 3，4，and 12 post-treatment compared to baseline，with the experimental group exhibiting lower scores than the control group at these time points. Homocysteine levels decreased in both groups compared to baseline，with the experimental group showing significantly lower levels than the control group（P<0.05）. Regarding Traditional Chinese Medicine syndrome scores，both groups showed significant reductions post-treatment compared to baseline（P<0.05），with the experimental group exhibiting a markedly greater decrease than the control group（P<0.05）. No adverse reactions occurred in either group throughout the study. [Conclusion] The combination of Tianma Gouteng Decoction with auricular holographic therapy demonstrates certain advantages in improving symptoms and related indicators in patients with HHT with insomnia due to liver yang hyperactivity. This treatment exhibits high safety during the therapeutic process and can be further explored and applied as an effective clinical approach for managing this condition.