天麻钩藤饮加减联合耳尖放血疗法治疗肝阳上亢型高血压临床观察  

Clinical Observation of Modified Tianma Gouteng Decoction Combined with Ear Tip Blood⁃letting in the Treatment of Hypertension with Liver-Yang Hyperactivity Syndrome

作　　者：邢军彪 和会静 王妙 李静 崔静娜 XING Junbiao;HE Huijing;WANG Miao;LI Jing;CUI Jingna(Tangxian Hospital of Traditional Chinese Medicine,Baoding,Hebei,China 072350)

机构地区：[1]河北省保定市唐县中医医院,河北保定072350

出　　处：《中国药业》2023年第14期95-98,共4页China Pharmaceuticals

基　　金：河北省中医药管理局科研计划项目[2022519]。

摘　　要：目的探讨天麻钩藤饮加减联合耳尖放血疗法治疗肝阳上亢型高血压的临床疗效。方法选取医院2020年1月至2022年1月收治的肝阳上亢型高血压患者300例,按随机抽签法分为对照组(100例)和观察组(200例)。两组患者均予耳尖放血疗法治疗,对照组患者加服硝苯地平控释片,观察组患者加服天麻钩藤饮(随证加减),两组均连续治疗4周。结果观察组总有效率为93.50%,显著高于对照组的77.00%(P<0.05)。观察组患者治疗后的中医证候(头痛眩晕、恶心欲呕、胸闷乏力、失眠烦躁)积分均显著低于对照组(P<0.05),24 h平均收缩压、24 h平均舒张压、24 h动态血压标准差、动态动脉硬化指数均显著低于对照组(P<0.05),尿微量白蛋白、尿肌酐清除率及两者的比值均显著低于对照组(P<0.05)。观察组与对照组不良反应发生率相当(13.00%比8.00%,P>0.05)。结论天麻钩藤饮加减联合耳尖放血疗法治疗肝阳上亢型高血压,能改善患者的中医证候,减小血压波动,改善动脉硬化和肾功能损伤程度。Objective To investigate the clinical efficacy of modified Tianma Gouteng Decoction combined with ear tip bloodletting in the treatment of hypertension with liver-Yang hyperactivity syndrome.Methods A total of 300 hypertensive patients with liver-Yang hyperactivity syndrome admitted to the hospital from January 2020 to January 2022 were selected and divided into the control group(100 cases)and the observation group(200 cases)by the random drawing method.The patients in the two groups were treated with ear tip bloodletting,on this basis,the patients in the control group were treated with Nifedipine Controlled-Release Tablets,while the patients in the observation group were treated with modified Tianma Gouteng Decoction.Both groups were treated continuously for four weeks.Results The total effective rate in the observation group was 93.50%,which was significantly higher than 77.00%in the control group(P<0.05).After treatment,the scores of traditional Chinese medicine(TCM)syndromes(headache,dizziness,nausea,vomiting,chest tightness,fatigue,insomnia and irritability)in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the 24-hour mean systolic blood pressure(24 hmSBP),24-hour mean diastolic blood pressure(24 hmDBP),standard deviation of 24-hour ambulatory blood pressure and ambulatory arterial stiffness index(AASI)in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the urinary microalbumin(MAU),urinary creatinine clearance rate and urinary microalbumin/creatinine ratio(ACR)in the observation group were significantly lower than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was similar to that in the control group(13.00%vs.8.00%,P>0.05).Conclusion Modified Tianma Gouteng Decoction combined with ear tip bloodletting in the treatment of hypertension with liver-Yang hyperactivity syndrome can improve the TCM syndromes,reduce the blood pressure fluctuation,improve the a

关 键 词：高血压 肝阳上亢证 天麻钩藤饮 耳尖放血疗法 血压波动性 动态动脉硬化指数 中医证候积分 肾功能 临床疗效 

分 类 号：R969.4[医药卫生—药理学] R544.1[医药卫生—药学]