不同服药方法对非勺型高血压患者疗效影响的研究  

Study of Different Medication on Treatment of Patients with Non-Dipper Hypertension

作　　者：杨玉萍 

机构地区：[1]广东省茂名市茂石化医院东院中心药房,525000

出　　处：《中华全科医学》2011年第7期1142-1143,共2页Chinese Journal of General Practice

摘　　要：目的探讨不同服药方法对于非勺型高血压患者血压昼夜节律的影响。方法对60例经24 h动态血压监测（ABPM）证实属于非勺型Ⅱ~Ⅲ级高血压患者,采取随机、平行对照设计分为两组。对照组30例早晨服用氨氯地平片（络活喜）和缬沙坦片（代文）,治疗组早晨服缬沙坦晚上服氨氯地平片,总疗程为4周,患者均于服药前及服药后4周进行24 h动态血压监测,比较两组血压昼夜节律的变化。结果治疗组、对照组总有效率分别为90%、83.3%,差异无统计学意义（P〉0.05）;两组用药后各时点收缩压及舒张压均低于用药前（P〈0.01）;治疗组夜间平均收缩压、夜间平均舒张压、晨峰血压升高程度、清晨收缩压、清晨舒张压、清晨脉压均较对照组低（P〈0.05）;治疗组血压昼夜变异率显著高于对照组（P〈0.05）。结论联合用药降压效果显著,早晚分次服药较早晨顿服两种药能更有效控制非勺型高血压,可以更好地改变血压昼夜节律,从而达到保护靶器官的目的 。Objective To explore the effect of different medication on blood pressure diurnal rhythm in patients with non-dipper hypertension.Methods 60 patients confirmed a non-dipper hypertensive（Ⅱ-Ⅲ grade） with 24h ambulatory blood pressure monitoring（ABPM） were enrolled and divided into two groups.30 patients in control group took Amlodipine（Norvasc） and valsartan（Diovan） in the morning,the treatment group took valsartan in the morning and amlodipine at night,the total duration of treatment was 4 weeks.Before and after 4 weeks treatment,changes in circadian rhythm of blood pressure were compared with 24-hour ambulatory blood pressure monitoring.Results The total effectiveness of treatment group and control group respectively were 90%,83.3%,the difference have no significance（P0.05）.After taking medications,systolic pressure and the diastolic pressure of the two groups were lower than before in various points time（P0.01）.The average systolic pressure,average diastolic pressure at night,the early morning peak blood pressure elevates the degree,early morning systolic pressure,early morning diastolic pressure and early morning pulse pressure of the treatment group were lower than the control group（P0.05）;the day and night blood pressure variation rate of the treatment group was higher than those of the control group（P0.05）.Conclusion The efficacy of reduce blood pressure was significant by combination with medication,taking drugs in the morning and evening separately was more efficacy than two drugs taking together in the morning to control non-dipper hypertension,which may change blood pressure diurnal rhythm better and achieve the goal of protecting target organ.

关 键 词：服药方法 非勺型高血压 氨氯地平 缬沙坦 

分 类 号：R544.1[医药卫生—心血管疾病]