通络养心方联合降压药治疗高血压合并左心室舒张功能不全的临床疗效研究  

Clinical efficacy of Tongluo Yangxin Recipe combined with anti-hypertensive drugs in treating hypertension patients complicated with left ventricular diastolic dysfunction

作　　者：唐园园 李华 TANG Yuanyuan;LI Hua(Department of General Internal Medicine,Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,Jiangsu Provincial Hospital of Traditional Chinese Medicine,Nanjing,Jiangsu,210029;Emergency Center,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Provincial People′s Hospital,Nanjing,Jiangsu,210029)

机构地区：[1]南京中医药大学附属医院/江苏省中医院普内科,江苏南京210029 [2]南京医科大学第一附属医院/江苏省人民医院急诊中心,江苏南京210029

出　　处：《实用临床医药杂志》2024年第6期94-98,共5页Journal of Clinical Medicine in Practice

基　　金：江苏省南京市科委基金课题项目(201715004)。

摘　　要：目的探讨通络养心方联合降压药治疗高血压合并左心室舒张功能不全的疗效以及对心功能和心室重构指标的影响。方法选取江苏省中医院收治的60例高血压合并左心室舒张功能不全患者为研究对象,随机分为研究组和对照组,每组30例。研究组给予西药降压联合中药汤剂治疗,对照组予以常规降压治疗。比较2组临床疗效、收缩压、舒张压以及心脏超声心室重构指标和左心室舒张指标。结果治疗后,研究组治疗总有效率为90.00%,高于对照组的66.67%,差异有统计学意义(P<0.05);治疗后,研究组中医证候总积分低于对照组,差异有统计学意义(P<0.05)。治疗后,2组收缩压、舒张压均较治疗前降低,且研究组收缩压、舒张压低于对照组,差异均有统计学意义(P<0.05)。治疗前及治疗后,研究组与对照组左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室后壁厚度(LVPWd)和左室射血分数(LVEF)的组间、组内比较,差异均无统计学意义(P>0.05)。研究组治疗后舒张早期峰值血流速度与舒张晚期峰值血流速度比值(E/A)、二尖瓣口舒张早期血流峰值速度与二尖瓣环侧壁及室间隔的舒张早期峰值速度的比值(E/e′)、E峰减速时间(EDT)改善情况优于对照组,差异有统计学意义(P<0.05)。研究组不良反应发生率为23.33%,对照组为26.67%,差异无统计学意义(P>0.05)。结论降压药基础上加用通络养心方可改善高血压合并左心室舒张功能不全患者的临床症状和疗效,且不影响心室重构指标。Objective To investigate the therapeutic effect of Tongluo Yangxin Recipe combined with anti-hypertensive drugs in the treatment of hypertension patients complicated with left ventricular diastolic dysfunction and its influence on cardiac function and ventricular remodeling indexes.Methods A total of 60 hypertension patients complicated with left ventricular diastolic dysfunction in Jiangsu Provincial Hospital of Traditional Chinese Medicine were selected as the research objects,and they were randomly divided into study group and control group,with 30 cases in each group.The study group was treated with anti-hypertensive drugs and traditional Chinese medicine decoction,while the control group was treated with conventional anti-hypertensive therapy.The clinical efficacy,systolic blood pressure,diastolic blood pressure,echocardiographic ventricular remodeling indexes,and left ventricular diastolic indexes were compared between the two groups.Results After treatment,the total effective rate in the study group was 90.00%,which was significantly higher than 66.67%in the control group(P<0.05);after treatment,the total score of TCM syndromes in the study group was significantly lower than that in the control group(P<0.05).After treatment,both systolic and diastolic blood pressures decreased significantly in both groups when compared with those before treatment,and systolic and diastolic blood pressures in the study group were significantly lower than those in the control group(P<0.05).Before and after treatment,there were no significant between-group and intra-group differences in left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left ventricular posterior wall thickness(LVPWd),and left ventricular ejection fraction(LVEF)between the study group and the control group(P>0.05).The improvement conditions of the ratio of peak flow velocity in early diastole to peak flow velocity in late diastole(E/A),the ratio of peak flow velocity in early diastole at the mitral orifice to peak flo

关 键 词：中西医结合 高血压 左心室舒张功能不全 临床疗效 

分 类 号：R544.1[医药卫生—心血管疾病] R242[医药卫生—内科学] R331.3[医药卫生—临床医学]