钩藤方治疗阳亢热毒证原发性高血压伴焦虑障碍的临床疗效及对炎症平衡的影响  

Gouteng Prescription Treats Primary Hypertension with Anxiety Disorder in Patients with Syndrome of Yang Hyperactivity and Heat Toxin:Clinical Efficacy and Impact on Balance of Inflammatory Cytokines

作　　者：王永成[1,2] 张仪美 徐向东 陈昌静[3] 王琳 王苏童[1] 田子芳 李晓 武继彪[1] WANG Yongcheng;ZHANG Yimei;XU Xiangdong;CHEN Changjing;WANG Lin;WANG Sutong;TIAN Zifang;LI Xiao;WU Jibiao(Shandong University of Traditional Chinese Medicine(TCM),Jinan 250014,China;Affiliated Hospital of Shandong University of TCM,Jinan 250014,China;The Second Affiliated Hospital of Shandong University of TCM,Jinan 250001,China)

机构地区：[1]山东中医药大学,济南250014 [2]山东中医药大学附属医院,济南250014 [3]山东中医药大学第二附属医院,济南250001

出　　处：《中国实验方剂学杂志》2023年第24期138-145,共8页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：山东省自然科学基金青年项目(ZR2020QH307);中国博士后科学基金面上项目(2021M702043);齐鲁中医药优势专科集群建设项目(鲁卫函[2021]2号)。

摘　　要：目的:探讨钩藤方治疗阳亢热毒证原发性高血压伴焦虑障碍的临床疗效及对炎症平衡的影响。方法:将98例诊断为原发性高血压伴焦虑症患者,随机分为两组,在高血压常规西医治疗基础上,对照组(47例)给予疏肝解郁胶囊治疗8周,观察组(51例)予以中药钩藤方治疗8周。比较两组患者血压水平、24 h血压变异性、汉密尔顿焦虑量表(HAMA)、匹兹堡睡眠质量指数(PSQI)、生活质量(SF-36量表)、中医证候积分及疗效、不良反应发生率,并检测外周血清白细胞介素(IL)-1β、IL-6、IL-10、IL-4水平。结果:最终完成试验观察病例95例,对照组46例,观察组49例。与本组治疗前比较,两组血压、血压变异性均降低(P<0.05,P<0.01);治疗后与对照组比较,观察组收缩压(SBP)、24 h平均收缩压(24 h SBP)、24 h收缩压变异性(24 h SBPV)、24 h舒张压变异性(24 h DBPV)改善程度优于对照组(P<0.05)。与本组治疗前比较,两组治疗后HAMA、PSQI评分均下降(P<0.05,P<0.01);治疗后与对照组比较,观察组HAMA、PSQI指标下降更明显(P<0.05)。与本组治疗前比较,两组治疗后SF-36生活质量评分均提高(P<0.05,P<0.01);治疗后与对照组比较,观察组生理功能(PF)、躯体疼痛(BP)、社会功能(SF)、情感职能(RE)、精神健康(MH)指标显著升高(P<0.05)。与本组治疗前比较,两组治疗后中医证候积分均下降(P<0.05,P<0.01)。治疗后与对照组比较,观察组中医证候积分明显降低(P<0.05)。观察组中医证候总有效率85.71%(42/49),对照组总有效率63.04%(29/46),观察组总有效率优于对照组(χ^(2)=6.621,P<0.05)。与本组治疗前比较,两组治疗后促炎因子(IL-1β、IL-6)水平下降,抑炎因子(IL-10、IL-4)水平升高(P<0.05,P<0.01);治疗后与对照组比较,观察组IL-1β、IL-6、IL-10、IL-4改善程度优于对照组(P<0.05)。研究过程无不良事件发生。结论:钩藤方能改善阳亢热毒证原发性高血压伴焦虑障碍患者的血压水�Objective:To explore the clinical efficacy of Gouteng prescription in treating the patients with primary hypertension with anxiety disorder due to yang hyperactivity and heat toxin and the impact of the formula on the balance of inflammatory cytokines.Method:A total of 98 patients diagnosed with primary hypertension and anxiety disorder were randomized into control and observation groups.On the basis of conventional western medicine treatment for hypertension,the control group(47 patients)was treated with Shugan Jieyu capsules for 8 weeks,while the treatment group(51 patients)with Gouteng prescription for 8 weeks.The two groups were compared in terms of the blood pressure level,24-hour blood pressure variability,Hamilton anxiety scale(HAMA)score,Pittsburgh sleep quality index(PSQI)score,quality of life(SF-36 scale)score,traditional Chinese medicine(TCM)syndrome score and efficacy,incidence of adverse reactions,and the levels of interleukin(IL)-1β,IL-6,IL-10,and IL-4 in the serum of peripheral blood.Result:The final trial was completed with 95 patients,including 46 in the control group and 49 in the observation group.The treatment in both groups lowered the blood pressure and blood pressure variability(P<0.05,P<0.01).The observation group outperformed the control group in recovering the systolic blood pressure(SBP),24-hour mean systolic blood pressure(24 h SBP),24-hour systolic blood pressure variability(24 h SBPV),and 24-hour diastolic blood pressure variability(24 h DBPV)(P<0.05).After treatment,the HAMA and PSQI scores in both groups decreased(P<0.05,P<0.01),and the observation group had lower HAMA and PSQI scores than the control group(P<0.05).Compared with those before treatment,the SF-36 scores in both groups increased(P<0.05,P<0.01).After treatment,the observation group had higher scores of physiological function(PF),bodily pain(BP),social function(SF),role-emotional(RE),and mental health(MH)indicators than the control group(P<0.05).After treatment,the TCM syndrome scores in both groups decreased(P<0.05,P<

关 键 词：原发性高血压 焦虑障碍 炎症平衡 钩藤方 阳亢热毒证 

分 类 号：R2-0[医药卫生—中医学] R22R242R287