左归丸合交泰丸加减辨治老年原发性高血压病合并失眠(肝肾阴虚证)的效果及机制  

Effect and Mechanism of Zuogui Pill(左归丸)and Jiaotai Pill(交泰丸)Treating Elderly Essential Hypertension with Insomnia(Syndrome of Liver-Kidney Yin Deficiency)

作　　者：高思妍[1] 王丽彦[1] 黄慧芹[1] 朱婷婷[1] GAO Siyan;WANG Liyan;HUANG Huiqin;ZHU Tingting(Department of Traditional Chinese Medicine,Beijing Sixth Hospital,Beijing 100007,China)

机构地区：[1]北京市第六医院中医科,北京100007

出　　处：《辽宁中医杂志》2021年第5期109-112,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：北京市东城区科技计划项目(2016-5-004)。

摘　　要：目的观察左归丸合交泰丸加减辨治老年原发性高血压病合并失眠(肝肾阴虚证)的效果,对起效机制进行初探。方法选择该院收治的88例老年原发性高血压病合并失眠患者,按照随机数字表分为对照组和观察组,每组各44例。对照组患者给予常规西药治疗;观察组患者在对照组的基础上加用左归丸合交泰丸加减方口服,连续治疗4周。比较24 h平均收缩压、24 h平均舒张压、睡眠时间、入睡时间、匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index, PSQI)评分变化,监测外周血中相关因子含量,观察临床效果及不良反应。结果观察组治疗失眠的临床效果更好,有效率高达93.18%(41/44),与对照组77.27%(34/44)的有效率相比,差异有统计学意义(χ^(2)=4.423,P<0.05);治疗后,与对照组相比,观察组的24 h SBP、24 h DBP、睡眠PSQI评分下降更明显,睡眠时间显著延长,入睡时间显著缩短(P<0.05);观察组的血清中25(OH)D、BDNF含量升高更明显,NE含量则降低更明显(P<0.05);两组患者均未见明显不良反应。结论左归丸合交泰丸加减方更利于控制老年原发性高血压合并失眠(肝肾阴虚证)患者的血压,提高睡眠质量,初步分析其可能与增加25(OH)D、BDNF含量及抑制NE分泌有关,用药安全,值得推广。Objective To observe the effect of Zuogui Pill(左归丸)combined with Jiaotai Pill(交泰丸)treating elderly essential hypertension with insomnia(syndrome of liver and kidney Yin deficiency)and explore the possible mechanism.Methods A total of 88 elderly patients with primary hypertension and insomnia admitted to our hospital were randomly divided into control group and observation group according to the random number table, with 44 patients in each group.Patients in the control group were treated with conventional western medicine.The patients in the observation group were treated with Zuogui Pill and Jiaotai Pill for 4 weeks on the basis of the control group.Changes in 24 h mean systolic blood pressure, 24 h mean diastolic blood pressure, sleep time, time to fall asleep and Pittsburgh sleep quality index(PSQI)score were compared.The contents of related factors in peripheral blood were monitored, and the clinical effect and adverse reactions were observed.Results The clinical effect of insomnia treatment in the observation group was better, with an effective rate of 93.18%(41/44),which was significantly higher than that in the control group[77.27%(34/44)](χ^(2)=4.423,P<0.05).After treatment, compared with the control group, the 24 h SBP,24 h DBP and sleep PSQI scores in the observation group were significantly decreased.The sleep time was significantly prolonged, and the sleep time was significantly shortened(P<0.05).The serum levels of 25(OH)D and BDNF in the observation group were significantly increased while the levels of NE were decreased more significantly(P<0.05).No significant adverse reactions were observed in the two groups.Conclusion Zuogui Pill combined with Jiaotai Pill is more conducive to controlling the blood pressure of patients with elderly primary hypertension complicated with insomnia(syndrome of liver and kidney Yin deficiency)and improving the sleep quality.Preliminary analysis shows that it may be related to the increase of 25(OH)D and BDNF and the inhibition of NE secretion.The drug is

关 键 词：原发性高血压 失眠 肝肾阴虚证 左归丸 交泰丸 临床效果 起效机制 

分 类 号：R259.441[医药卫生—中西医结合]