申时行调督熄风针法联合西药治疗肝阳上亢非杓型高血压临床观察  

Therapeutic effect of TiaoduXifeng acupuncture and Western medicine during 3-5 pm for patients with ascendent hyperactivity of liver yang type non-dipper hypertension

作　　者：梁燕[1] 鲍晓华 李晨梅 高慧[1] 王艳君[3] 刘田莉 LIANG Yan;BAO Xiaohua;LI Chenmei;GAO Hui;WANG Yanjun;LIU Tianli(Shijiazhuang Hospital of TCM,Shijiazhuang 050051,China)

机构地区：[1]石家庄市中医院,石家庄050051 [2]丰宁满族自治县中医院 [3]河北省中医院 [4]河北北方学院研究生院

出　　处：《山东医药》2019年第25期18-21,共4页Shandong Medical Journal

基　　金：河北省中医药管理局基金资助项目(2016095);河北省财政厅基金资助项目(361025)

摘　　要：目的观察申时(下午3~5时)行调督熄风针法联合西药对肝阳上亢非杓型高血压的治疗效果。方法将60例肝阳上亢型非杓型高血压患者随机分为对照组、治疗组各30例。对照组给予马来酸左旋氨氯地平片2.5mg口服,1次/d,晨起顿服。治疗组给予马来酸左旋氨氯地平片口服(方法同对照组)联合调督熄风针法治疗,调督熄风针法治疗时间为下午3~5点,1次/d,5次/周,2周为1个疗程。两组均治疗4周。治疗前后监测两组动态血压,计算夜间血压下降率,统计治疗后杓型血压患者比例,治疗前后统计血压负荷、晨峰血压(MBPS),用放射免疫法检测血浆内皮素(ET),硝酸还原法检测血清一氧化氮(NO)。结果治疗后两组动态血压均低于治疗前(P均<0.05),治疗组夜间平均收缩压、夜间平均舒张压低于对照组(P均<0.05);治疗后两组夜间血压下降率高于治疗前(P<0.05),且治疗组高于对照组(P<0.05);治疗后治疗组杓型血压比例高于对照组(P<0.05);治疗后两组血压负荷、MBPS均低于治疗前(P均<0.05),治疗组夜间收缩压负荷、夜间舒张压负荷、MBPS均低于对照组(P均<0.05);治疗后治疗组血浆ET水平低于对照组(P均<0.05),血清NO水平高于对照组(P均<0.05)。结论申时行调督熄风针法联合西药治疗可逆转肝阳上亢非杓型高血压患者的非杓型结构,降低血压负荷、MBPS,改善血压昼夜节律及血管内皮功能。Objective To investigate the therapeutic effect of TiaoduXifeng acupuncture and Western medicine during 3-5 pm for patients with ascendent hyperactivity of liver yang type non-dipper hypertension. Methods Sixty patients with ascendent hyperactivity of liver yang type non-dipper hypertension were randomly divided into the control group and the treatment group.The patients in the control group were given Lamlodipine maleate 2.5 mg,once a day,and served in the morning.The patietns in the treatment group were given orally-administered levamlodipine maleate (method with the control group) combined with the treatment of TiaoduXifeng acupuncture,the treatment time was 3 to 5 pm,1 time/d,5 times/week,and 2 weeks/course.Both groups were treated for 4 weeks.The dynamic blood pressure of the two groups was monitored before and after treatment,the rate of nocturnal blood pressure of the two groups was calculated,the proportion of patients in dipper hypertension of the two groups was monitored.The blood pressure and morning blood pressure peak (MBPS) were monitored,and the radioimmunoassay method was used to detect the plasma endothelin (ET),and the nitrate reduction method for detecting NO. Results The dynamic blood pressure of the two groups after treatment were lower than that before treatment ( P <0.05).The nighttime mean systolic blood pressure (nMSBP) and the nighttime mean diastolic blood pressure (nMDBP) were lower in the treatment group than in the control group (both P <0.05).The rate of nocturnal blood pressure decreased in both groups after treatment ( P <0.05),and the rate in the treatment group was higher than that in the control group ( P <0.05).The proportion of non-dipper blood pressure in the treatment group after treatment was higher than that in the control group ( P <0.05).The blood pressure load and MBPS of the two groups after treatment were lower than those before treatment (both P <0.05).The nighttime systolic blood pressure load (nSBPL),the nighttime diastolic blood pressure load (nDBPL),and MBPS of

关 键 词：非杓型高血压 调督熄风针法 申时 肝阳上亢 血压昼夜节律 血压负荷 晨峰血压 内皮素 一氧化氮 

分 类 号：R544.1[医药卫生—心血管疾病]