天麻钩藤饮干预肝阳上亢型高血压病的临床疗效及机制探讨

The clinical efficacy and mechanism of Tianma Gouteng Decoction in intervention of hypertension of liver-yang hyperactivity

关键词:  天麻钩藤饮  肝阳上亢型高血压病  肾素-血管紧张素-醛固酮系统

Key words:  Tianma Gouteng Decoction  hypertension of liver-yang hyperactivity  RAAS

摘要:

[目的] 讨论临床应用天麻钩藤饮治疗肝阳上亢型高血压病的疗效及可能的降压作用机制。[方法] 选取60例肝阳上亢型高血压病患者，依据随机数字表，随机将这些高血压病患者分为对照组、治疗组，每组患者各30例。对照组采纳惯例西医疗法，治疗组在此基础上加服天麻钩藤饮汤剂，测量治疗前后血压，计算中医临床症状积分，评价降压疗效，检测两组患者血浆中的肾素（PRA）、血管紧张素Ⅰ（AngⅠ）、血管紧张素Ⅱ（AngⅡ）和醛固酮（ALD）水平。[结果] 治疗2周后，天麻钩藤饮联合西药能显著降低肝阳上亢型高血压病患者的收缩压和舒张压水平，比单纯西药治疗高血压病的降压疗效更好，而且还能显著改善肝阳上亢型高血压病患者的头晕头痛、急躁易怒、口苦口干、目赤面红等典型症状。而单纯应用西药不能有效改善患者急躁易怒、口苦口干、目赤面红等症状。另外，天麻钩藤饮结合西药能明显降低肝阳上亢型高血压病患者的血浆AngⅡ和ALD水平，与对照组相比，其降幅水平更显著。[结论] 天麻钩藤饮是经临床实际证明有效的降压方剂，能显著改善患者临床症状，其机制与抑制肾素-血管紧张素-醛固酮系统（RAAS）相关。

Abstract:

[Objective] To discuss the clinical efficacy of Tianma Gouteng Decoction (TGD) in the treatment of hypertension of liver-yang hyperactivity and its possible hypotensive mechanism.[Methods] Observe 60 clinically hypertensive patients with liver-yang hyperactivity,and randomly divide these hypertensive patients into a control group and a treatment group according to a random number table,with 30 patients in each group. The control group adopted conventional western medical treatment. On this basis,the treatment group was given TGD to measure blood pressure before and after treatment,calculate traditional Chinese medicine clinical syndrome scores,evaluate the antihypertensive effect,and detect the plasma renin (PRA),angiotensin Ⅰ(Ang Ⅰ),angiotensin Ⅱ(Ang Ⅱ) and aldosterone (ALD) levels.[Results] After 2 weeks of treatment,TGD combined with western medicine can significantly reduce the systolic and diastolic blood pressure of hypertensive patients with liver-yang hyperactivity. Compared with pure western medicine for hypertension,the antihypertensive effect of TGD is better. TGD can also significantly improve the typical symptoms of dizziness,headache,irritability,bitter mouth,dry mouth,red eyes and face in hypertensive patients with liver-yang hyperactivity. Western medicine alone cannot effectively improve symptoms such as irritability,irritability,dry mouth,red eyes and face. In addition,TGD combined with western medicine can significantly reduce the plasma AngⅡ and ALD levels in hypertensive patients with liver-yang hyperactivity,and its reduction level is more significant compared with pure western medicine.[Conclusion] TGD is a clinically proven antihypertensive prescription that can significantly improve the symptoms of patients. The mechanism of TGD to lower blood pressure is related to the inhibition of RAAS.