同仁牛黄清心丸联合替米沙坦片治疗高血压性眩晕痰热上扰证的临床研究  

Clinical study of Tongren Niuhuang Qingxin Pills combined with Telmisartan in the treatment of hypertensive vertigo syndrome of phlegm-heat disturbance

作　　者：岳春梅 肖延龄 龙晓华 孔繁飞 续晓彤 冯燕佼 赵晶晶 刘权 董春娇 唐铭 杨阳[5] Yue Chunmei;Xiao Yanling;Long Xiaohua;Kong Fanfei;Xu Xiaotong;Feng Yanjiao;Zhao Jingjing;Liu Quan;Dong Chunjiao;Tang Ming;Yang Yang(Inpatient Department,Beijing Tongrentang Hospital of Traditional Chinese Medicine,Beijing 100051,China;Internal Department,Beijing Tongrentang Hospital of Traditional Chinese Medicine,Beijing 100051,China;Department of Science and Education,Beijing Tongrentang Hospital of Traditional Chinese Medicine,Beijing 100051,China;Department of Spine,Beijing Tongrentang Hospital of Traditional Chinese Medicine,Beijing 100051,China;Science Data Research Laboratory of TCM,Institute of Traditional Chinese Medicine Information,China Academy of Traditional Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京同仁堂中医医院综合病区,北京100051 [2]北京同仁堂中医医院内科,北京100051 [3]北京同仁堂中医医院科教部,北京100051 [4]北京同仁堂中医医院脊柱科,北京100051 [5]中国中医科学院中医药信息研究所中医药科学数据研究室,北京100700

出　　处：《国际中医中药杂志》2024年第5期588-593,共6页International Journal of Traditional Chinese Medicine

基　　金：2020年度北京市中医药科技发展资金项目(JJ-2020-28)。

摘　　要：目的评价同仁牛黄清心丸联合替米沙坦片治疗高血压性眩晕痰热上扰证的临床疗效,观察药物安全性。方法随机对照试验研究。选取2021年3月-2022年8月北京同仁堂中医医院80例高血压性眩晕痰热上扰证患者作为观察对象,采用随机数字表法分为2组,每组40例。对照组口服替米沙坦片,试验组在对照组基础上加服同仁牛黄清心丸。2组均治疗28 d,随访1个月。分别于治疗前后测量患者诊室血压,并进行中医证候评分,采用眩晕评定量表的评分系统(DARS)评估眩晕严重程度,记录治疗期间不良反应并观察药物安全性,评价临床疗效。结果试验组总有效率为85.0%(34/40)、对照组为7.5%(3/40),2组比较差异有统计学意义(χ^(2)=48.32,P<0.001)。与同组治疗前比较,试验组治疗后收缩压(SBP)[(136.63±6.01)mmHg比(159.30±9.01)mmHg,t=-21.00]、舒张压(DBP)[(84.48±4.36)mmHg比(95.30±3.75)mmHg,t=-13.80];对照组治疗后SBP[(137.34±6.39)mmHg比(158.00±10.06)mmHg,t=-5.28]、DBP[(86.08±4.43)mmHg比(95.18±6.61)mmHg,t=-8.09]降低(P<0.001),但2组治疗后比较,差异无统计学意义(P>0.05)。治疗后,试验组中医证候积分[(8.68±3.39)分比(15.12±3.03)分,Z=-6.61]、DARS评分[(8.53±3.93)分比(12.20±3.95)分,Z=-3.63]低于对照组(P<0.001)。试验组治疗后中医证候疗效指数较同组治疗前改善,各症状疗效指数由高到低依次为自身或视物旋转>肢体麻木>大便干>头晕目眩>喜冷饮>口苦口干>小便赤>舌质红苔黄腻>吐黏稠浊痰>耳鸣>脉滑数。2组治疗期间未出现明显不良反应。结论同仁牛黄清心丸联合替米沙坦片可降低高血压性眩晕痰热上扰证患者的血压,改善患者眩晕症状和中医证候,疗效优于单纯替米沙坦片治疗。Objective To observe the clinical efficacy and safety of Tongren Niuhuang Qingxin Pills combined with telmisartan tablets in the treatment of hypertensive vertigo syndrome of phlegm-heat disturbance.Methods Randomized controlled trial was conducted.Totally 80 patients with hypertension vertigo and phlegm-heat disturbance syndrome were selected from March 2021 to August 2022 at Beijing Tongrentang Hospital of Traditional Chinese Medicine as the observation objects.They were randomly divided into two groups using a random number table method,with 40 cases in each group.The control group received oral telmisartan tablets,while the experimental group received Tongren Niuhuang Qingxin Pills in addition to the control group.Both groups were treated for 28 days and followed up for 1 month.The patients'room blood pressure before and after treatment was measured,and TCM syndrome scores were evaluated.The dizziness assessment rating scale(DARS)was used to evaluate the severity of dizziness,adverse reactions during treatment were recorded,drug safety was observed,and clinical efficacy was evaluated.Results The total effective rate of the experimental group was 85.0%(34/40),and that of the control group was 7.5%(3/40),with statistical significance between the two groups(χ^(2)=48.32,P<0.001).Compared with before treatment,the experimental group had SBP[(136.63±6.01)mmHg vs.(159.30±9.01)mmHg,t=-21.00]and DBP[(84.48±4.36)mmHg vs.(95.30±3.75)mmHg,t=-13.80]after treatment;after treatment,SBP[(137.34±6.39)mmHg vs.(158.00±10.06)mmHg,t=-5.28]and DBP[(86.08±4.43)mmHg vs.(95.18±6.61)mmHg,t=-8.09]decreased in the control group(P<0.01),but there was no statistical significance between the two groups after treatment(P>0.05).After treatment,the TCM syndrome scores in the experimental group(8.68±3.39 vs.15.12±3.03,Z=-6.61)were lower than those in the control group(P<0.001),and DARS score[(8.53±3.93)vs.(12.20±3.95),Z=-3.63]was lower than that in the control group(P<0.001).After treatment,the therapeutic effect index of TCM synd

关 键 词：高血压 眩晕 痰热上扰证 同仁牛黄清心丸 替米沙坦片 

分 类 号：R544.1[医药卫生—心血管疾病]