苯磺氨氯地平联合养血清脑颗粒对高血压亚急症伴急性头痛患者的临床疗效  

The clinical effect of benzene sulfonic amlodipine combined with Yangxueqingnao granules on patients with hypertensive urgencies with acute headache

作　　者：刘盼 郑文武 李正业 黄立[2] 蒋灿 黄冬梅 刘茜 

机构地区：[1]西南医科大学附属医院心内科,四川泸州646000 [2]四川省叙永县人民医院心内科,四川叙永646400

出　　处：《中国中西医结合急救杂志》2017年第3期253-256,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：四川省科技支撑计划（14ZC0066）

摘　　要：目的 观察苯磺氨氯地平联合中药养血清脑颗粒治疗高血压亚急症（HU）伴急性头痛患者的临床疗效及对血清脑源性神经营养因子（BNDF）的影响.方法 采用前瞻性研究方法,选择2014年1月至2016年12月西南医科大学附属医院心内科诊治的HU伴急性头痛患者186例,按随机数字表法分为对照组（90例）和观察组（96例）.对照组给予苯磺氨氯地平口服,每次10 mg,每日1次;观察组在对照组基础上给予中药养血清脑颗粒每次4 g,每日3次,连续治疗7 d.比较两组治疗前后平均动脉压（MAP）、头痛性质和部位及血清BDNF含量的差异,用视觉模拟评分法（VAS）评价头痛程度,并观察两组临床疗效.结果 两组治疗前和治疗后2 h及1、3、7 d MAP（mmHg,1 mmHg=0.133 kPa）比较差异均无统计学意义（对照组分别为99.7±9.5、94.2±9.1、88.6±7.6、81.8±9.3、75.6±5.3,观察组分别为95.4±13.5、91.2±8.1、88.9±8.7、83.2±8.6、77.2±4.8,均P〉0.05）.与对照组比较,观察组治疗后1、3、7 d急性头痛性质（钝痛、胀痛）、头痛部位（全头部）例数均明显减少〔钝痛（例）：16、8、3比28、24、18,胀痛（例）：11、6、2比22、16、10,全头部（例）：12、5、3比26、20、16,均P〈0.05〕.随治疗时间延长,两组治疗后VAS评分均逐渐降低,于治疗后7 d达到最低水平,且观察组的降低程度较对照组更显著（分：0.5±0.4比1.4±0.9）,两组治疗后1 d起BNDF均逐渐升高,于治疗7 d达到最高水平,且观察组的升高程度较对照组更显著（ng/L：24.8±2.3比17.8±2.2）.治疗后观察组有效率明显高于对照组〔70.8%（68/96）比53.3%（48/90）,P〈0.05〕.结论 苯磺氨氯地平联合中药养血清脑颗粒能有效缓解HU患者急性头痛症状,其机制与BDNF表达增加有关.Objective To observe the clinical effect of benzene sulfonic amlodipine combined with traditional Chinese medicine （TCM） Yangxueqingnao granules for treatment of patients with hypertensive urgencies （HU） with acute headache, and its effect on serum brain derived neurotrophic factor （BDNF） level.Methods A prospective study was conducted, 186 HU patients with acute headache admitted to the Department of Cardiology in the Affiliated Hospital of Southwest University from January 2014 to December 2016 were enrolled, and they were divided into a control group （90 cases） and an observation group （96 cases） by random number table method. The patients in control group received benzene sulfonic amlodipine （10 mg, once a day） and the patients in observation group were additionally given Yangxueqingnao granules （4 g, 3 times a day for consecutive 7 days） on the basis of treatment in control group. The mean arterial pressure （MAP）, the nature and location of headache and the levels of serum BNDF were examined before and after treatment and compared between them in the two groups, the degree of headache was evaluated by visual analogue scale （VAS）, and the clinical therapeutic effects in the two groups were observed.Results There were no statistical significant differences in MAP （mmHg, 1 mmHg = 0.133 kPa） between the two groups before treatment and at 2 hours, on 1, 3, 7 days after treatment （control group： 99.7±9.5, 94.2±9.1, 88.6±7.6, 81.8±9.3, 75.6±5.3 respectively, the observation group： 95.4±13.5, 91.2±8.1. 88.9±8.7, 83.2±8.6, 77.2±4.8 respectively, allP 〉 0.05）. Compared with the control group, after treatment for 1, 3, 7 days, the nature of acute headache （dull pain, distending pain） was relieved more significantly, the number of patients with whole head headache was decreased more obviously in observation group [dull pain （cases）： 16, 8, 3 vs. 28, 24, 18, distending pain （cases）： 11, 6, 2 vs. 22, 16, 10, whole head pain （cases）： 12, 5, 3

关 键 词：苯磺氨氯地平 高血压亚急症 头痛 急性 养血清脑颗粒 脑源性神经营养因子 

分 类 号：R277.772[医药卫生—中医学]