天麻钩藤颗粒联合替米沙坦对原发性老年2级高血压Klotho蛋白水平的影响  

Effect of Tianma Gouteng Granules Combined with Telmisartan on Klotho Protein Level in Patients with Grade 2 Senile Primary Hypertension

作　　者：杜敏 李莉[1] 吕鹏 张华芳[2] 陈国华[2] DU Min;LI Li;LYU Peng;ZHANG Hua-Fang;CHEN Guo-Hua(Weifang Medical College,Weifang 261000 Shandong,China;Weifang People*s Hospital,Weifang 261000 Shandong,China)

机构地区：[1]潍坊医学院,山东潍坊261000 [2]潍坊市人民医院,山东潍坊261000

出　　处：《广州中医药大学学报》2020年第2期206-212,共7页Journal of Guangzhou University of Traditional Chinese Medicine

摘　　要：【目的】观察天麻钩藤颗粒联合替米沙坦对肝阳上亢型原发性老年2级高血压患者疗效及Klotho蛋白水平的影响。【方法】选取108例肝阳上亢型原发性老年2级高血压患者,排除服药不规律和服药后不耐受的3例患者后,将105例患者随机分为治疗组53例和对照组52例。2组患者均给予口服阿司匹林肠溶片和瑞舒伐他汀钙片的基础治疗,对照组同时给予口服替米沙坦治疗,治疗组在对照组基础上加用天麻钩藤颗粒治疗,疗程为12周。观察2组患者治疗前后收缩压(SBP)、舒张压(DBP)、血清一氧化氮(NO)、内皮素1(ET-1)及Klotho蛋白水平的变化情况,并评价2组的中医证候疗效。【结果】(1)经治疗12周后,治疗组的总有效率为83.02%,对照组为61.54%,治疗组的中医证候疗效明显优于对照组(P<0.05)。(2)治疗后,2组患者的SBP和DBP均较治疗前明显下降(P<0.05),且治疗组对SBP、DBP的下降作用均明显优于对照组(P<0.05)。(3)治疗后,2组患者血清ET-1水平均较治疗前降低(P<0.05),血清NO和Klotho蛋白水平均较治疗前升高(P<0.05),且治疗组对ET-1水平的降低作用及对NO、Klotho蛋白水平的升高作用均优于对照组(P<0.05)。(4)Pearson相关性分析:血清Klotho蛋白及NO水平与患者SBP呈负相关(r=-0.802和r=-0.503,P<0.05),ET-1水平与患者SBP呈正相关(r=0.325,P<0.05)。【结论】天麻钩藤颗粒联合替米沙坦治疗肝阳上亢型原发性老年2级高血压的疗效确切,能有效降低患者血压,改善患者临床症状,升高患者血清Klotho蛋白水平,其疗效优于单纯西药治疗。Objective To investigate the therapeutic effect of Tianma Gouteng Granules combined with telmisartan tablets in treating patients with grade 2 senile primary hypertension of liver-yang hyperactivity syndrome and the influence on the Klotho protein level.Methods One hundred and eight patients with grade 2 senile primary hypertension of liver-yang hyperactivity syndrome were enrolled into the study.After excluding 3 cases who had irregular medication and were intolerant to the medicine,the left 105 cases were randomized into treatment group(n=53)and control group(n=52).Both groups were given fundamental treatment with aspirin enteric-coated tablets and rosuvastatin calcium tablets orally,and additionally,the control group was given telmisartan tablets orally and the treatment group was given oral use of Tianma Gouteng Granules plus telmisartan tablets.The treatment lasted 12 weeks.Before and after treatment,the changes of systolic blood pressure(SBP),diastolic blood pressure(DBP),and serum levels of nitric oxide(NO),endothelin 1(ET-1)and Klotho protein in the two groups were observed.After treatment for 12 weeks,the efficacy for traditional Chinese medicine(TCM)syndromes was compared between the two groups.Results(1)After treatment for 12 weeks,the total effective rate for TCM syndromes in the treatment group was 83.02%and that in the control group was 61.54%,the efficacy in the treatment group being superior to that in the control group(P<0.05).(2)After treatment,SBP and DBP in the two groups were obviously decreased(P<0.05 compared with those before treatment),and the decrease in the treatment group was superior to that in the control group(P<0.05).(3)After treatment,serum ET-1 level was decreased and NO and Klotho protein levels were increased in the two groups(P<0.05 compared with those before treatment),and the effects on decreasing ET-1 and on increasing NO and Klotho protein in the treatment group were stronger than those in the control group(P<0.05).(4)The results of Pearson correlation analysis showed that

关 键 词：天麻钩藤颗粒 替米沙坦 老年高血压 肝阳上亢证 血管内皮功能 KLOTHO蛋白 

分 类 号：R259.441[医药卫生—中西医结合]