酒石酸美托洛尔片联合中药汤剂治疗老年原发性高血压合并慢性心力衰竭临床观察  

Clinical observation of metoprolol tartrate tablets combined with Chinese herbal decoction on essential hypertension complicated with heart failure of elderly patients

作　　者：张彬 

机构地区：[1]河北省永清县人民医院心血管内科,河北永清065000

出　　处：《河北中医》2018年第2期241-246,共6页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察酒石酸美托洛尔片联合中药汤剂治疗老年原发性高血压合并慢性心力衰竭的临床疗效。方法将306例老年原发性高血压合并慢性心力衰竭患者随机分为3组。治疗组102例予酒石酸美托洛尔片联合中药汤剂治疗;对照1组102例予酒石酸美托洛尔片联合吲达帕胺片治疗;对照2组102例予单纯酒石酸美托洛尔片治疗。3组均10 d为1个疗程,治疗3个疗程。比较3组疗效,观察3组治疗前后血清骨桥蛋白(OPN)、血浆B型脑钠肽(BNP)水平变化和血液流变学指标[全血黏度(低切)、全血黏度(高切)、血浆黏度、红细胞聚集指数]变化。结果治疗组总有效率97.06%,对照1组总有效率94.12%,对照2组总有效率84.31%,治疗组、对照1组总有效率高于对照2组(P<0.05),治疗组、对照1组疗效优于对照2组。治疗组与对照1组总有效率比较差异无统计学意义(P>0.05),2组疗效相当。3组治疗后OPN、BNP水平均较本组治疗前降低(P<0.05),治疗后治疗组、对照1组OPN、BNP水平均低于对照2组(P<0.05),治疗后治疗组与对照1组OPN、BNP水平比较差异均无统计学意义(P>0.05)。3组治疗后全血黏度、血浆黏度、红细胞聚集指数均较本组治疗前降低(P<0.05),治疗后治疗组、对照1组全血黏度、血浆黏度、红细胞聚集指数均低于对照2组(P<0.05),治疗后治疗组与对照1组全血黏度、血浆黏度、红细胞聚集指数比较差异均无统计学意义(P>0.05)。治疗组不良反应发生率(11.77%)低于对照1组(28.43%)和对照2组(30.39%)(P<0.05),而对照1组与对照2组不良反应发生率比较差异无统计学意义(P>0.05)。结论酒石酸美托洛尔片联合中药汤剂治疗老年原发性高血压合并慢性心力衰竭具有良好疗效,并能有效降低OPN、BNP水平,改善血液流变学指标。Objective To observe clinical effects of metoprolol tartrate tablets combined with Chinese herbal decoction on essential hypertension complicated with heart failure of elderly patients.Methods 306 elderly patients with essential hypertension complicated with heart failure were randomly divided into three groups.102 cases in treatment group were treated by metoprolol tartrate tablets combined with Chinese herbal decoction.102 cases in control group 1 were treated by metoprolol tartrate tablets combined with indapamide tablets.102 cases in control group 2 were treated by metoprolol tartrate tablets.A treatment course was 10 d that continuously treatment for three courses in three groups.The clinical effects were compared,and the level changes of serum osteopontin(OPN),plasma B-type brain natriuretic peptide(BNP) and hemorheology parameters including whole blood viscosity(low cut),whole blood viscosity(high cut),plasma viscosity,and erythrocyte aggregation index changes before and after treatment were observed in three groups.Results The total effective rate in treatment group,control group 1 and control group 2 was 97.06%,94.12% and 84.31% respectively.The total effective rate of the treatment group and the control group 1 were higher than that of the control group 2(P < 0.05).The curative effect of treatment group and control group 1 were better than that of the control group 2.There was no significant difference in the total effective rate between treatment group and control group 1(P > 0.05).The efficacy of the two groups was comparable.The levels of OPN and BNP after treatment were significantly lower than those before treatment in three groups(P < 0.05),and the levels of OPN and BNP in the treatment group and control group 1 after treatment were lower than those in the control group 2 after treatment(P < 0.05).There was no significant difference in the levels of OPN and BNP after treatment between the treatment group and the control group 1(P > 0.05).The whole blood viscosity,plasma viscosity,and erythrocyte a

关 键 词：高血压 心力衰竭 中西医结合疗法 

分 类 号：R544.110.58[医药卫生—心血管疾病] R541.610.58[医药卫生—内科学]