补肾填精方治疗老年原发性高血压的疗效及对血管重塑、炎症状态的影响  

Effect of Bushen Tianjing Decoction on Elderly Primary Hypertension and Its Influence on Vascular Remodeling and Inflammatory State

作　　者：李明[1] 王硕[1] LI Ming;WANG Shuo(Physical Examination Department of Qinhuangdao Hospital,Peking University Third Hospital,Qinhuangdao Hebei066000,China)

机构地区：[1]北京大学第三医院秦皇岛医院体检科,河北秦皇岛066000

出　　处：《四川中医》2023年第3期75-79,共5页Journal of Sichuan of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(编号:2020367,滋阴补肾填精益髓法在老年性高血压的应用)。

摘　　要：目的:探讨补肾填精方治疗老年原发性高血压的疗效及对血管重塑、炎症状态的影响。方法:选取2020年3月~2022年3月本院收治的老年原发性高血压患者150例,随机分为对照组与观察组,每组75例。对照组予以苯磺酸氨氯地平片口服治疗,观察组在对照组基础上予以补肾填精方服用,两组均连续治疗4周。比较两组降压疗效和安全性;于治疗前和治疗后,行中医证候积分和健康调查简表(SF-36)的评定,并行血压指标[24 h平均收缩压(24hSBP)、24h平均舒张压(24hDBP)]、血管硬化指标[踝肱指数(ABI)、肱踝脉搏波传导速度(baPWV)、颈总动脉内膜-中层厚度(IMT)]、血管内皮功能[内皮素(ET-1)、一氧化氮(NO)]及炎症因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]的测定。结果:观察组降压总有效率为92.96%,显著高于对照组的80.56%,差异有统计学意义(P<0.05)。治疗后,观察组中医证候积分及24hSBP、24hDBP水平显著低于对照组(P<0.05),SF-36评分显著高于对照组(P<0.05)。治疗后,观察组ABI显著高于对照组(P<0.05),baPWV和IMT显著低于对照组(P<0.05)。治疗后,观察组ET-1及CRP、TNF-α、IL-6水平显著低于对照组(P<0.05),NO水平显著高于对照组(P<0.05)。两组不良反应对比差异无统计学意义(P>0.05)。结论:对于老年原发性高血压,补肾填精方不仅能够提高降压疗效,还可改善患者微炎症状态及血管内皮功能,抑制血管重塑,对于防治靶器官损害有着积极作用。Objective To investigate the effect of Bushentianjing decoction on elderly patients with essential hypertension and its influence on vascular remodeling and inflammation.Methods A total of 150elderly primary hypertension patients admitted to our hospital from March 2020to March 2022were randomly divided into the control group and the observation group,with 75cases in each group.The control group was treated with amlodipine besylate tablets orally,and the observation group was treated with Bushen Tianjing decoction on the basis of the control group.Both groups were treated continuously for 4weeks.The antihypertensive efficacy and safety of the two groups were compared.Before and after treatment,TCM syndrome score and SF-36were evaluated.Blood pressure indexes[24h mean systolic blood pressure(24hSBP),24h mean diastolic blood pressure(24hDBP)],vascular sclerosis indexes[ankle brachial index(ABI),brachial-ankle pulse wave velocity(baPWV),common carotid artery intima-media thickness(IMT)],vascular endothelial function[endothelin(ET-1),nitric oxide(NO)]and inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)]were detected.Results The total effective rate of blood pressure reduction in the observation group was 92.96%,which was significantly higher than 80.56%in the control group,and the difference was statistically significant(P<0.05).After treatment,the TCM syndrome score and the levels of 24hSBP and 24hDBP in the observation group were significantly lower than those in the control group(P<0.05),and the SF-36score was significantly higher than the control group(P<0.05).After treatment,ABI in the observation group was significantly higher than in the control group(P<0.05),baPWV and IMT were significantly lower than those in the control group(P<0.05).After treatment,the levels of ET-1,CRP,TNF-αand IL-6in the observation group were significantly lower than those in the control group(P<0.05),and the level of NO was significantly higher than the control group(P<0.05).There was

关 键 词：原发性高血压 补肾填精方 血管重塑 血管内皮功能 炎症 

分 类 号：R544.1[医药卫生—心血管疾病]