益气化聚方联合常规疗法治疗代谢综合征高血压病的临床研究  

Effect of Yiqi Huaju Recipe Combined with Routine Therapy in Treating Hypertension Patients with Metabolic Syndrome: a Clinical Study

作　　者：陈熤 符德玉[2] 傅晓东[1] 何燕铭[3] 王文健[1] 

机构地区：[1]复旦大学附属华山医院中西医结合科,上海200040 [2]上海中医药大学附属岳阳中西医结合医院心内科,上海200437 [3]上海中医药大学附属岳阳中西医结合医院内分泌科,上海200437

出　　处：《中国中西医结合杂志》2014年第6期680-687,共8页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然青年科学基金资助项目(No.81001574)

摘　　要：目的研究益气化聚方联合常规疗法对代谢综合征高血压病患者血压幅度、血压变异性和其他心血管危险因子的影响。方法 43例代谢综合征高血压病患者,随机分为治疗组(基础治疗+益气化聚方)22例与对照组(基础治疗+安慰剂)21例,疗程为12周。治疗前后测量形体学指标;检测血糖,包括空腹和餐后2 h血糖(2 hour postprandial plasma glucose,2 h PPG)、糖化血红蛋白A1c(fasting glycosylated hemoglobin A1c,HbA1c)、空腹胰岛素(fasting plasma insulin,FPI)、稳态模型胰岛素抵抗指数(homeostatic model assessment for insulin resistance,HOMA-IR)和血脂等;进行24 h动态血压监测(ambulatory blood pressure monitoring,ABPM)。结果治疗组治疗后形体学检测指标和血糖水平(除HbA1c外)较治疗前明显降低(P<0.01,P<0.05),且在腰围、腰臀比(waist-to-hip ratio,WHR)、2 h PPG、FPI和HOMA-IR方面低于对照组(P<0.05);与治疗前比较,治疗组治疗后各时段平均血压幅度、血压变异性及各时段血压负荷有改善(P<0.01,P<0.05),且部分指标优于对照组(P<0.01,P<0.05)。结论益气化聚方联合常规治疗能更好地控制代谢综合征高血压病患者的血压幅度、血压变异性和血压负荷,同时能有效降低患者的其他心血管病风险。Objective To investigate the therapeutic effect of Yiqi Huaju Recipe （YHR） combined with routine therapy on the blood pressure, the blood pressure variability and other cardiovascular risk factors in hypertension patients complicated with metabolic syndrome （MetS）. Methods Totally 43 hypertension patients complicated with MetS were recruited in this study and randomly assigned to the treatment group （22 cases, treated with basic routine treatment ＋YHR） and the control group （21 cases, treated with basic routine treatment ＋ placebo）. The treatment course was 12 weeks. Detected were parameters such as 24-h ambulatory blood pressure monitoring （ABPM）, body mass index （BMI）, waist circumference （WC）, waist to hip ratio （WHR）, homeostatic model assessment for insulin resistance （HOMA-IR）, fasting glycosylated hemoglobin Alc （ HbAlc）, fasting plasma glucose （ FPG）, 2 h postprandial plasma glucose （2 h PPG）, fasting plasma insulin （FPI）, serum lipid, etc. Results The anthropometric parameters and plasma glucose levels （except HbAlc） were obviously lowered after treatment than before treatment in the treatment group （P 〈0.01, P 〈0.05）. Besides, better effects were obtained in the WC, WHR, 2 h PPG, FPI and HOMA-IR （P 〈0.05）. The average blood pressure amplitude, the blood pressure variability, and blood pressure load at any time point were more obviously improved in the two groups after treatment than before treatment （P 〈0.01, P 〈0.05）. Besides, partial indices were better in the treatment group than in the control group （P 〈 0.01, P 〈 0.05）. Conclusions YHR combined with routine therapy exhibited better effect on reducing the blood pressure amplitude, the blood pressure variability, and the blood pressure load in hypertension patients complicated with MetS. It could also effectively decrease the risk of other vascular disease.

关 键 词：代谢综合征 高血压病 动态血压监测 血压变异性 血压负荷 益气化聚方 

分 类 号：R544.1[医药卫生—心血管疾病]