补肾和脉方对老年单纯收缩期高血压动脉僵硬度的干预效应  

Intervention of Arterial Stiffness in Elderly Hypertension Patients with Bushen Hemai Recipe

作　　者：陆峰[1,2,3] 杨传华[1,2,3] 袁杰 刘杨[1] 陈文静 王震[1] 

机构地区：[1]山东中医药大学附属医院心内科,山东济南250011 [2]国家中医药管理局高血压病血脉理论及应用重点研究室,山东济南250011 [3]高血压国家中医临床研究基地,山东济南250014

出　　处：《广州中医药大学学报》2013年第6期786-791,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：山东省科技发展计划项目(编号:2007GG30002012);山东省中医药科技发展计划项目(编号:2007-038);山东省保健医学科研计划课题(编号:2007BZ15)

摘　　要：【目的】探讨补肾和脉方对高血压高危患者动脉弹性功能(管壁僵硬度)的影响。【方法】采用随机、单盲、对照研究方法。于2周洗脱期后,在年龄60～79岁、脉压(PP)≥60 mmHg的1级和2级单纯收缩期高血压(ISH)肾虚证(包括肾气虚、肾阴虚、肾阳虚)患者中,比较左旋氨氯地平+吲哒帕胺(对照组,N=58)和左旋氨氯地平+吲哒帕胺+补肾和脉方(试验组,N=57)对坐位收缩压(SBP)、PP和臂踝脉搏波传导速度(baPWV)的近期影响,疗程为24周。【结果】在意向性分析(ITT)人群中,与对照组比较,试验组baPWV降幅更为显著;校正基线差异后,组间baPWV自基线的平均降幅(95%CI)分别为-131(-193,-69)cm/s和-281(-328,-233)cm/s,差异有统计学意义(P<0.001)。此外,SBP平均降幅、PP平均降幅、血压达标率(SBP<140 mmHg且PP<60 mmHg)、SBP达标率和PP达标率的组间比较差异均有统计学意义(P<0.01)。【结论】补肾和脉方能进一步改善ISH的动脉僵硬度,提高SBP/PP的控制率,可能具有延缓血管衰老的优势。Objective To observe the effect ofBushen Hemai Recipe （BHR） on arterial wall stiffness in elderly hypertension patients. Methods Randomized, single-blind, control design was adopted. After the washout period of two weeks, the short-term effect of levamlodipine ＋ indapamide （control group , N = 58） and levamlodipine ＋ indapamide ＋ BHR （ experimental group , N= 57） on sitting systolic blood pressure （SBP）, pulse pressure （PP） and brachial-ankle pulse wave velocity （baPWV） were compared in isolated systolic hypertension （ISH） patients of three kidney deficiency syndromes at stage 1 and 2 with PP ≥ 60 mmHg and aged 60 to 79 years old. Results At the end of treatment for 24 weeks, baPWV of the experimental group was decreased more significantly in the ITT population as compared with that of the control group. After adjustment of baseline differences, baPWV average reduction from baseline （95% CI） was -131 （-193, -69） cm/s in the control group and was -281 （-328, -233） cm/s in the experimental group （P 〈0.001） . In addition, SBP average reduction, PP average reduction, the rate of blood pressure meeting the normal levle （SBP 〈 140mmHg and PP 〈60mmHg） , and the rate of SBP and PP meeting the normal level all showed significant differences between the two groups （ P 〈0.01 ） . Conclusion BHR exerts certain effect on alleviating ISH arterial stiffness, and improving the rate of SBP/PP meeting the normal level, which shows advantages of delaying the aging of vessels .

关 键 词：单纯收缩期高血压 中药疗法 补肾和脉方 治疗应用 动脉僵硬度 脉搏波传导速度 

分 类 号：R544.1[医药卫生—心血管疾病]