半夏白术天麻汤对原发性高血压痰浊中阻证患者左心室能量损耗的影响  

Effect of Banxia Baizhu Tianma Decoction on Energy Loss within the Left Ventricle in Essential Hypertension with the Syndrome of Phlegm Turbidity and Obstruction

作　　者：张希惠 王飞[1] 丁文波[2] 阎芹[2] 李杰[2] 王新东[2] 杨丽君[2] 高昕[2] 吴娜 陈晓栋[2] ZHANG Xihui;WANG Fei;DING Wenbo;YAN Qin;LI Jie;WANG Xindong;YANG Lijun;GAO Xin;WU Na;CHEN Xiaodong(The Third Clinical Medical College,Nanjing University of Chinese Medicine,Nanjing 210023,China;Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210028,China)

机构地区：[1]南京中医药大学第三临床医学院,江苏南京210023 [2]南京中医药大学附属中西医结合医院,江苏南京210028

出　　处：《中国中医药信息杂志》2023年第11期162-166,共5页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：国家中医临床研究基地开放课题(JD2019SZ15);江苏省研究生科研与实践创新计划项目(SJCX22-0851);全国西学中骨干人才培训项目(19QGXXZGGRC001);全国名老中医药专家董其美传承工作室建设项目(2022年)。

摘　　要：目的观察半夏白术天麻汤对原发性高血压痰浊中阻证患者左心室能量损耗(EL)的影响。方法采用随机数字表法将64例原发性高血压痰浊中阻证患者分为试验组和对照组各32例。2组均在健康教育基础上予硝苯地平控释片,30 mg/次,1次/d,口服;试验组加服半夏白术天麻汤,每日1剂,每日2次,口服。2组均连续治疗6周。观察2组临床疗效,比较2组治疗前后中医症状评分、平均血压、常规超声心动图指标和血流向量成像(VFM)技术测量心房收缩期(P1)、快速射血期(P2)、快速充盈期(P3)及减慢充盈期(P4)左心室EL。结果试验组总有效率为90.63%(29/32),对照组为78.13%(25/32),2组比较差异有统计学意义(P<0.05)。与本组治疗前比较,2组治疗后中医各项症状评分均降低(P<0.05,P<0.01);2组治疗后比较,试验组首重如裹、脘腹痞满评分及总分低于对照组(P<0.05)。与本组治疗前比较,2组治疗后平均血压均降低(P<0.01);2组治疗后平均血压比较差异无统计学意义(P>0.05)。2组治疗前后常规超声心动图指标比较差异无统计学意义(P>0.05)。与本组治疗前比较,2组治疗后EL-P1、EL-P2、EL-P3、EL-P4均减小(P<0.01);2组治疗后比较,试验组EL-P1、EL-P2、EL-P3、EL-P4减小趋势更明显(P<0.01)。结论半夏白术天麻汤可改善原发性高血压痰浊中阻证患者的症状及提高临床疗效,可改善血液流变进而减少左心室EL,可能有助于改善心功能、延缓心室重塑进程。Objective To observe the effects of Banxia Baizhu Tianma Decoction on energy loss(EL)within the left ventricle in essential hypertension with the syndrome of phlegm turbidity and obstruction.Methods Totally 64 patients with essential hypertension with the syndrome of phlegm turbidity and obstruction were divided into an experimental group and a control group using a random number table method,with 32 cases in each group.On the basis of health education,two groups of patients were given nifedipine,30 mg/time,once a day,and the experimental group was additionally treated with Banxia Baizhu Tianma Decoction,one dosage a day,twice a day,orally.The treatment for both group lasted for 6 weeks.The clinical efficacy of both groups was observed.TCM syndrome score,mean blood pressure,and conventional echocardiographic indicators before and after treatment in both groups were compared.Left ventricular EL during atrial contraction(P1),rapid ejection(P2),rapid filling(P3),and slow filling(P4)were measured using vector flow mapping(VFM)technology.Results The total effective rate was 90.63%(29/32)in the experimental group and 78.13%(25/32)in the control group,with statistical significance(P<0.05).Compared with before treatment,the TCM syndrome scores in the two groups significantly decreased after treatment(P<0.01,P<0.05);after treatment,the scores of head with binding sensation,distention and fullness and total scores of the experimental group were lower than those of the control group(P<0.05).Compared with before treatment,the average blood pressure in the two groups decreased after treatment(P<0.01),there was no significant difference between the two groups after treatment(P>0.05).There was no significant difference in all routine ultrasound indexes between the two groups before and after treatment(P>0.05).Compared with before treatment,EL-P1,EL-P2,EL-P3 and EL-P4 in the two groups decreased after treatment(P<0.01);after treatment,the decreasing trend of EL-P1,EL-P2,EL-P3 and EL-P4 in the experimental group was more obvious(

关 键 词：原发性高血压 半夏白术天麻汤 血流向量成像 痰浊中阻证 左心室能量损耗 

分 类 号：R259.441[医药卫生—中西医结合]