柴胡加龙骨牡蛎汤加味治疗轻中度原发性高血压合并抑郁肝阳上亢证的临床观察  

Efficacy and Safety of Modified Chaihu Jia Longgu Muli Tang in Treating Mild to Moderate Essential Hypertension Complicated with Depression and Liver-Yang Hyperactivity Syndrome

作　　者：汤艳莉[1] 王继明 庄庭怡[1] 杨萃[1] 付金萍[1] TANG Yan-li;WANG Ji-ming;ZHUANG Ting-yi;YANG Cui;FU Jin-ping(Tianjin TEDA Hospital,Tianjin 300457,China)

机构地区：[1]天津市泰达医院,天津300457

出　　处：《中国实验方剂学杂志》2020年第13期132-137,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家重点研发计划重点专项(2018YFC17044901);天津市“131”创新型人才培养工程。

摘　　要：目的:探讨柴胡加龙骨牡蛎汤加味对轻中度原发性高血压合并抑郁肝阳上亢证的临床有效性与安全性,并评估其对血管内皮功能的影响。方法:选择2016年2月至2018年5月在天津市泰达医院门诊患者,现代医学符合轻中度原发性高血压合并抑郁诊断标准,中医诊断符合肝阳上亢证的患者共121例,随机分为治疗组(60例)和对照组(61例)。两组患者均给予基础西药降压治疗,治疗组在基础西药方案的基础上,服用中药柴胡加龙骨牡蛎汤加味方,每天1剂,2次/d。疗程为4周。观察治疗前后治疗组和对照组两组患者的血压、患者健康问卷抑郁自评量表(PHQ-9)评分,中医证候积分,C反应蛋白,内皮依赖性血管舒张功能及不良反应。结果:与本组治疗前比较,两组患者治疗后血压均能降低(P<0.05),组间比较,治疗后治疗组血压较对照组下降(P<0.05)。治疗后治疗组PHQ-9评分,肝阳上亢证积分,C反应蛋白水平均较对照组降低(P<0.05)。与对照组治疗后比较,治疗组细胞依赖性舒张功能(FMD)和内皮细胞非依赖性舒张功能(GTN)水平升高(P<0.05)。两组患者均未见显著不良反应。结论:柴胡加龙骨牡蛎汤加味在治疗轻中度原发性高血压合并抑郁患者具有一定临床疗效,能在降压的同时,还能改善抑郁、改善中医证候、减轻炎性反应,改善内皮依赖性血管舒张功能,且具有较好的安全性,体现了中医药治疗高血压的多靶点、多成分、整体综合调节优势。Objective: To observe the clinical efficacy and safety of modified Chaihu Jia Longgu Muli Tang in treating mild to moderate essential hypertension complicated with depression and liver-Yang hyperactivity syndrome. Method: Totally 121 mild to moderate hypertensive patients complicated with depression in line with the inclusive criteria were randomized into treatment group and control group. All of the enrolled patients in treatment group and control group were treated with conventional therapy. In treatment group,patients were given modified Chaihu Jia Longgu Muli Tang,one dose per day. The treatment course lasted for 4 weeks. Blood pressure,patient health questionnaire-9(PHQ-9)score,score of traditional Chinese medicine syndrome,C-reactive protein(CRP),endothelial-dependent vasodilation,and adverse effect were observed in this study. Result: Both systolic blood pressure and diastolic blood pressure were significantly lowered when compared to control group(P<0. 05). PHQ-9 score was significantly improved in treatment group(P<0. 05). The score of traditional Chinese medicine syndrome was significantly improved in treatment group compared to control group(P<0. 05). CRP was significantly improved in treatment group compared with control group(P<0. 05). Endothelial-dependent vasodilation was significantly improved in treatment group compared with control group(P<0. 05). No severe adverse effect was observed in this research. Conclusion:Chaihu Jia Longgu Muli Tang has a creation clinical efficacy in the treatment of mild to moderate essential hypertension with depression. In addition to the effect in reducing both systolic and diastolic blood pressure,modified Chaihu Jia Longgu Muli Tang was also effective in improving depression,traditional Chinese medicine syndrome and endothelial-dependent vasodilation,and reducing the level of CRP with little adverse effect.

关 键 词：柴胡加龙骨牡蛎汤加味方 高血压 抑郁 肝阳上亢证 内皮依赖性血管舒张功能 患者健康问卷抑郁自评量表(PHQ-9)评分 

分 类 号：R22[医药卫生—中医基础理论] R242[医药卫生—中医学]