综合方法治疗老年性高血压疗效观察  

The curative effect of comprehensive treatments for senile hypertension

作　　者：胡玉姿 周学华 

机构地区：[1]浙江省庆元县疾病预防控制中心疾控科,323800 [2]浙江省庆元县人民医院内科

出　　处：《中国基层医药》2015年第18期2823-2826,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：探索以综合全程的方法治疗老年性高血压，并与传统西药治疗进行疗效比较，为今后指导临床高血压的治疗提供借鉴。方法选择老年性高血压患者162例，按照收治的先后顺序以及知情同意的原则，随机分为观察组和对照组，对照组仅给予常规的西药联合治疗，即硝苯地平缓释片联合厄贝沙坦片。观察组按照健康管理的思路，建立健康档案，评估患者心血管风险等级后按照危险程度差异化治疗。低、中危的连续监测血压，开展健康教育，重点干预其生活方式，建立良好心态，血压控制不稳的再考虑用药。对于高危与很高危的患者，除去上述治疗外，需要马上用药并辅以中药汤剂治疗。观察组每月随访1次，随访6个月后测量血压，评估治疗有效率和不良反应情况。结果观察组总有效率为96．7％（89／92），显著高于对照组的82．8％（58／70）（χ^2＝9．12，P ＜0．01），差异有统计学意义。观察组随访6个月后，观察组的收缩压降至（126．1±21．5）mmHg（t ＝7．548，P ＜0．01）；舒张压降至（79．5±9．5）mmHg（t ＝10．703，P ＜0．01），比入院时有显著下降。对照组随访6个月后，收缩压降至（145．3±26．7）mmHg（t ＝1．979，P ＜0．05），有明显下降，舒张压有所下降，但差异无统计学意义（P ＞0．05）。观察组患者的降压效果更好，且两组患者不良反应均较小，差异无统计学意义。结论在健康管理的思路下，对患者进行全程的治疗，提高患者对于高血压的知晓率，建立健康的生活方式，科学合理的用药，这些方法的综合运用可以有效的提高老年性高血压的治疗效果，值得推广和应用。Objective To study comprehensive methods for senile hypertension and compared with conven-tional western medicine treatment,and provide reference to guide clinical hypertension treatment for the future. Methods 162 cases with senile hypertension were selected in our hospital,according to the order of treatment and the principle of informed consent,they were randomly divided into observation group and control group.The control group was given conventional western medicine treatment,the Nifedipine sustained release tablets joint irbesartan tab-lets.Based on the thinkings of health management,we established health records for observation group firstly,then as-sessed cardiovascular risk among patients.The patients with low,moderate risk were conducted the continuous monito-ring of blood pressure,health education,the key intervention in their way of life,established a good mentality.If the blood pressure was still unstable and out of control,we began to consider the use of drug.For patients with high risk or very high risk,besides the treatment considered,they needed immediate medical treatment supplemented by traditional Chinese medicine.Observation group was followed up for 1 time,and lasting for 6 months,then their blood pressure was measured again,the treatment effect and adverse reactions were evaluated.Results The total effective rate of ob-servation group was 96.7% （89 /92）,which was significantly higher than that of control group 82.8% （58 /70）,χ^2 =9.12,P 〈0.01,the difference was statistically significant.After following up for 6 months,the systolic blood pressure of observation group fell to （126.1 ±21.5 ）mmHg,t =7.548,P 〈0.01;diastolic blood pressure fell to （79.5 ±9.5）mmHg,t =10.703,P 〈0.01,the change was significantly different than before.The systolic blood pres-sure of control group fell to （145.3 ±26.7）mmHg,t =1.979,P 〈0.05,there was markedly reduced,diastolic blood pressure decreased too,but there was no statistical difference （P 〉0.05）.So the effect of observatio

关 键 词：综合方法 老年 高血压 

分 类 号：R544.1[医药卫生—心血管疾病]