谷精草汤化裁方对肝郁化火证高血压病患者血压、肾素活性、血管紧张素Ⅱ及醛固酮的影响  

Effects of Gujingcao Modified Formula on Blood Pressure,Renin Activity,AngiotensinⅡand Aldosterone in Patients with Hypertension Induced by Syndrome of Liver Depression Transforming into Fire

作　　者：赵存方 王强[2] 李惠洲 史佳森 王春亮 毕俊芳[3] 崔晓慧 万鑫苗 申雪娜 ZHAO Cunfang;WANG Qiang;LI Huizhou;SHI Jiasen;WANG Chunliang;BI Junfang;CUI Xi-aohui;WAN Xinmiao;SHEN Xuena(Department of Cadre Ward,the 980th Hospital of Joint Logistic Support Force of Chinese PLA,Shijiazhuang 050082,China;the Third Department of CardiologyShijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang 050051,China;Department of Integrative Chinese and Western Medicine,Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang 050051,China;Department of Anesthesiology,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China;the First Department of Cardiology,the Eighth People's Hospi-tal of Hebei Province,Shijiazhuang 050011,China;Department of Geriatrics,the First Hospital of Baoding City,Baod-ing,Hebei 071066,China)

机构地区：[1]联勤保障部队第九八〇医院干部病房,石家庄050082 [2]石家庄市中医院心三科,石家庄050051 [3]石家庄市中医院中西医结合科,石家庄050051 [4]河北医科大学第三医院麻醉科,石家庄050051 [5]河北省第八人民医院心一科,石家庄050051 [6]保定市第一医院老年病科,河北保定071066

出　　处：《临床误诊误治》2024年第9期89-94,共6页Clinical Misdiagnosis & Mistherapy

基　　金：河北省中医药管理局2023年度中医药类科研计划项目课题(2023152)。

摘　　要：目的观察谷精草化裁方联合厄贝沙坦片治疗对肝郁化火证高血压病患者血压、肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)及醛固酮(ALD)水平的影响。方法选取2022年1月-2023年2月收治的80例肝郁化火证高血压病,按照随机数字表法分为2组,对照组40例予厄贝沙坦片治疗,观察组40例在对照组基础上加用谷精草化裁方治疗,2组均治疗8周。比较2组治疗前后血压相关指标、中医证候积分和血清PRA、AngⅡ和ALD水平变化,以及治疗期间不良反应情况。结果治疗8周后,观察组总有效率为92.50%(37/40)高于对照组的75.00(30/40)(P<0.05)。治疗后,2组日间收缩压、日间舒张压、夜间收缩压、夜间舒张压、24 h收缩压、24 h舒张压、血压负荷均较治疗前下降,且观察组优于对照组(P<0.05)。治疗后,观察组各项中医证候积分下降,而对照组仅眩晕、头痛积分降低(P<0.05);治疗后,观察组各项中医证候积分优于对照组(P<0.05)。2组治疗后血清PRA较治疗前升高,AngⅡ和ALD较治疗前降低(P<0.05);观察组治疗后PRA水平高于对照组,AngⅡ和ALD水平低于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论谷精草汤化裁方联合厄贝沙坦片治疗肝郁化火证高血压病,可降低患者血压,改善患者临床症状,并能有效抑制AngⅡ和ALD水平,效果显著且安全。Objective To observe the effects of Gujingcao modified formula combined with Irbesartan tablets on blood pressure,plasma renin activity(PRA),angiotensinⅡ(AngⅡ)and aldosterone(ALD)levels in patients with hypertension induced by syndrome of liver depression transforming into fire.Methods From January 2022 to February 2023,80 patients with hypertension induced by syndrome of liver depression transforming into fire were selected and divided into two groups ac-cording to random number table method.Of them,40 patients in the control group were treated with Irbesartan tablets,and 40 patients in the observation group were treated with Gujingcao modified formula on the basis of the control group.Both groups were treated for 8 weeks.Blood pressure-related indexes,TCM syndrome scores,serum levels of PRA,AngⅡand ALD,and adverse reactions during treatment were compared between the two groups before and after treatment.Results At 8 weeks af-ter treatment,the total effective rate of observation group was 92.50%(37/40),which was higher than that of control group[75.00(30/40)](P<005).After treatment,daytime systolic blood pressure(SBP),daytime diastolic blood pressure(DBP),nighttime SBP,nighttime DBP,24 h SBP,24 h DBP and blood pressure load in the two groups were decreased com-pared with those before treatment,which were better in the observation group than in the control group(P<005).After treatment,the scores of all TCM syndromes in the observation group decreased,while the scores of only dizziness and head-ache in the control group decreased(P<005).The scores of TCM syndromes in the observation group were better than those in the control group(P<005).After treatment,serum PRA in the two groups was higher than that before treatment,while AngⅡand ALD were lower than those before treatment(P<005).After treatment,PRA level in the observation group was higher than that in the control group,while AngⅡand ALD levels were lower than those in the control group(P<005).There was no significant difference in the incidence of ad

关 键 词：高血压 肝郁化火 谷精草汤化裁方 血压 中医证候 肾素活性 血管紧张素Ⅱ 醛固酮 

分 类 号：R544.1[医药卫生—心血管疾病]