时辰化服用国家基本药物(依那普利、吲达帕胺)治疗高血压病临床观察  

Clinical Observation of Chrono-Therapy on Hypertension with the National Essential Drugs Enalapril and Indapamide

作　　者：朱欣荣[1] 张雪姣[1] 林中[1] 

机构地区：[1]深圳市福田区慢性病防治院,广东深圳518048

出　　处：《药品评价》2011年第10期34-37,共4页Drug Evaluation

基　　金：2010年深圳市科技计划项目;项目编号:201003250

摘　　要：目的: 探讨时辰化服用国家基本药物(依那普利、吲达帕胺)治疗Ⅱ型高血压病的疗效。方法:试验组(时辰化服药组)和对照组(常规化服药组)各随机选取Ⅱ型高血压患者200例,试验组根据血压节律类型及依那普利和吲达帕胺的药代动力学特点选择不同的给药时间点:对照组每天上午8:00服用吲达帕胺2 5m g,1次/日,依那普利10mg,1次/日。结果:试验组白昼平均收缩压/舒张压(dMSBP/dM DBP)、夜间平均收缩压/舒张压(nMSB P/nMDBP)、24小时平均收缩压/舒张压(24hMSBP/24hMDBP)、平均动脉压(MA P)、血压晨峰(MBPS)等相关临床指标均有显著下降,试验组比对照组下降明显(P<0 01),服药治疗1年后试验组24h血压变异小,降压峰谷比值(T/P)高,对照组24h血压变异大,降压峰谷比值(T/P)低。结论:吲达帕胺及依那普利按时辰化服用可平稳、有效控制24h血压,降低昼夜整体血压水平,有效抑制清晨时段血压的快速上升,能最大限度降低血压波动。Objective： To investigate the effect of Chrono-Therapy with the national essential drugs （ Enalapril and Indapamide） in patients with type 11 hypertension. Methods： 400 patients were selected from 600 cases of type 11 hypertension patients and grouped randomly to chrono-therapy group and control group （200 patients each group）. In chrono-therapy group, the drug administration time is determined by patients＇ blood pressure rhythm and the pharmacokinetic characteristics of enalapril and indapamide. Dipper patiants were given indapamide 2.5 mg qd, at 6：00 am, po, and enalapril 10 mg qd, 12：00 n, po; over-dipper or extreme-dipper were given indapamide 2.5 mg qd, at 6：00 am, po, and enalapril 10 mg qd, 6：00 am, po; non-dipper and opposited-dipper were given indapamide 2.5 mg qd, at 6：00 am, po, and enalapril 10 mg qd, 9：00 pm, po. 200 cases in control group received routine medication therapy： indapamide 2.5 mg and enalapril 10 mg at 8：00, am, po. Results. After 1 year treatment, the relevant clinical parameters such as dMSBP/dMDBP, nMSBP/nMDBP, 24hMSBP/24hMDBP, MAP and MBPS were significantly reduced in both groups, But the parameters in chrono-therapy group decreased more dramatically than in control group （P 〈0.01）. After 1 year treatment, the variability of 24 h blood pressure in chrono-therapy group is smaller than in control group. The peak blood pressure ratio （T/P） in chrono-therapy group is higher than in control group. Conclusions. Taking Indapamide and enalapril by schedule can control the 24h blood pressure smoothly and effectively. Chrono-therapy also can inhibit the rapid increase of blood pressure in the early morning and minimize the blood pressure fluctuations.

关 键 词：时辰化服药 高血压 国家基本药物 

分 类 号：R544.1[医药卫生—心血管疾病]