更年平脉汤联合缬沙坦治疗冲任失调型围绝经期高血压临床研究  

Clinical Study on Gengnian Pingmai Decoction Combined with Valsartan for Hypertension of Disharmony of the Chong and Ren Mai Type in Perimenopausal Period

作　　者：王一帆 桂明泰[1] 符德玉[1] WANG Yifan;GUI Mingtai;FU Deyu

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海每200437

出　　处：《新中医》2023年第10期75-80,共6页New Chinese Medicine

基　　金：国家自然科学基金面上项目(81774111);上海中医药大学产业发展中心医养结合科创项目(YYKC-2021-01-157)。

摘　　要：目的:观察更年平脉汤联合缬沙坦治疗冲任失调型围绝经期高血压的临床疗效。方法:选取120例冲任失调型围绝经期高血压患者,采用随机数字表法分为观察组和对照组,每组60例,对照组剔除2例,观察组剔除1例,最终纳入研究对照组58例,观察组59例。观察组给予更年平脉汤联合缬沙坦治疗,对照组仅予以缬沙坦治疗,2组均治疗12周。评估2组临床疗效,比较2组治疗前后中医证候积分,促卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇(E_(2))、总胆固醇(TC)、低密度脂蛋白(LDL)、甘油三酯(TG)水平,以及24 h平均收缩压(24 hSBP)、24 h平均舒张压(24 hDBP)、24 h收缩压变异系数(24 hSBPcv)、24 h舒张压变异系数(24 hDBPcv)。结果:治疗后,观察组临床疗效总有效率91.53%,高于对照组67.24%(P<0.05)。治疗后,2组中医证候积分均较治疗前降低(P<0.05),观察组中医证候积分低于对照组(P<0.05)。治疗后,2组24 hSBP、24 hDBP、24 h SBPcv均较治疗前降低(P<0.05),观察组24 hDBPcv较治疗前降低(P<0.05),对照组24 hDBPcv与治疗前比较,差异无统计学意义(P>0.05);观察组24 hSBP、24 hDBP、24 hSBPcv、24 hDBPcv均低于对照组(P<0.05)。治疗后,观察组血清FSH及LH水平均较治疗前降低,且均低于对照组(P<0.05);观察组血清E2水平较治疗前升高,且高于对照组(P<0.05)。对照组治疗前后血清FSH、LH、E_(2)水平比较,差异均无统计学意义(P>0.05)。治疗后,2组TG水平均较治疗前降低(P<0.05),观察组TG水平低于对照组(P<0.05);观察组TC、LDL水平均较治疗前降低,且均低于对照组(P<0.05)。对照组治疗前后TC、LDL水平比较,差异均无统计学意义(P>0.05)。结论:在缬沙坦基础上使用更年平脉汤治疗可以降低冲任失调型围绝经期高血压患者的平均血压,缓解围绝经期症状,调节雌激素及脂代谢水平。Objective:To observe the clinical effect of Gengnian Pingmai Decoction combined with Valsartan for hypertension of disharmony of the chong and ren mai type in perimenopausal period.Methods:A total of 120 cases of patients with hypertension of disharmony of the chong and ren mai type in perimenopausal period were selected and divided into the observation group and the control group according to the random number table method,with 60 cases in each group.Two cases in the control group and one case in the observation group were excluded.Finally,58 cases in the control group and 59cases in the observation group were included.The observation group was treated with Gengnian Pingmai Decoction combined with Valsartan,and the control group was simply treated with Valsartan.Both groups were treated for 12 weeks.The clinical effects in the two groups were evaluated.Before and after treatment,the traditional Chinese medicine(TCM)syndrome scores,the levels of follicle stimulating hormone(FSH),luteinizing hormone(LH),estrogen(E_(2)),total cholesterol(TC),low density lipoprotein(LDL),and triglyceride(TG),24-hour mean systolic blood pressure(24 hSBP),24-hour mean diastolic blood pressure(24 hDBP),24-hour systolic blood pressure coefficient of variation(24 h SBPcv),and24-hour diastolic blood pressure coefficient of variation(24 hDBPcv)were compared between the two groups.Results:After treatment,the total clinical effective rate was 91.53%in the observation group,higher than that of 67.24%in the control group(P<0.05).After treatment,TCM syndrome scores in the two groups were decreased when compared with those before treatment(P<0.05),and the TCM syndrome score in the observation group was lower than that in the control group(P<0.05).After treatment,24 hSBP,24 hDBP and 24 h SBPcv in the two groups were decreased when compared with those before treatment(P<0.05),the 24 h DBPcv in the observation group was lower than that before treatment(P<0.05),and there was no significant difference being found in the comparison of 24 h DBPcv in th

关 键 词：高血压病 围绝经期 冲任失调 更年平脉汤 缬沙坦 雌激素 脂代谢 

分 类 号：R544.1[医药卫生—心血管疾病]