天麻钩藤饮对原发性高血压患者动态血压及颈动脉中膜-内膜厚度、左室重构的影响

Evaluation of ambulatory blood pressure and Carotid intima-media thickness and left ventricular remodeling of Tianma Gouteng decoction in patients with essential hypertension

关键词:  原发性高血压  颈动脉中膜-内膜厚度  左室重构  天麻钩藤饮

Key words:  essential hypertension  Carotid intima-media thickness  left ventricular remodeling  Tianma Gouteng decoction

摘要:

[目的] 观察天麻钩藤饮对轻中度原发性高血压患者(肝阳上亢证)降压效果及颈动脉中膜-内膜厚度、左室重构的影响。[方法] 将60例轻中度原发性高血压(肝阳上亢证)患者随机分为两组, 分别为天麻钩藤饮组(治疗组)和盐酸贝那普利组(对照组), 口服治疗各6个月后, 检测治疗前后两组患者24 h动态血压水平, 计算其血压平滑指数(SI), 并检测颈动脉中膜-内膜厚度(IMT), 左室重量指数(LVMI).[结果] 研究结果显示, 经过6个月的治疗, 治疗组治疗前后24 h平均动态收缩压(SBP)差异有统计学意义(P<0.01), 白天平均SBP及平均舒张压(DBP)均显着降低(P<0.01), 夜间平均SBP及平均DBP均明显降低(P<0.05), 白天降幅大于夜间。血压平滑指数:治疗组和对照组患者治疗后均具有较高的平滑指数, 两组比较差异无统计学意义。两组治疗前后IMT比较差异有统计学意义 (P<0.01), 两组治疗后比较差异有统计学意义(P<0.05).两组治疗前后LVMI差异有统计学意义(P<0.01), 两组治疗后比较无统计学差异。[结论] 提示天麻钩藤比盐酸贝那普利具有更好的降压作用, 具有同样的降压平滑指数, 对颈动脉粥样硬化、心脏重构有逆转作用。

Abstract:

[Objective] To research the effect of ambulatory blood pressure and Carotid intima-media thickness and left ventricular remodeling of Tianma Gouteng decoction. [Methods] The study is to divide 60 patients into test group and control group randomly, who were treated with Tianma Gouteng decoction and Benazepril hydrochloride respectively for 6 months. Measure changes of 24 h tendence blood pressure, BP smooth index,intima media thickness(IMT). [Results] After 6 month's therapy, changes of 24 h tendencies blood pressure, either average systolic pressure (SBP) or diastolic pressure (DBP) (P<0.05) of days or nights, significantly decreased, especially in days P<0.05) with nights(P<0.001). Of smooth index, both of them got high results by SBP and DBP but no significant different. But intima media thickness(IMT) results show significant differency by Tianma Gouteng decoction group(P<0.05 or P<0.001).LVMI results show significantly decreased with the two groups. [Conclusion] This study show that Tianma Gouteng decoction have same efficacy in lowering the 24 h blood pressure, compared with Benazepril hydrochloride, even superior to Benazepril hydrochloride in day BP control and reverse Carotid IMT and left ventricular remodeling.