桑芪滋阴补肾汤治疗阴虚阳亢证高血压颈动脉硬化患者的疗效及对其血清炎性因子和血管内皮功能的影响  

Efficacy of Sangqi Ziyin Bushen Decoction in Treating Hypertensive Patients with Carotid Atherosclerosis Characterized by Yin Deficiency and Yang Hyperactivity Syndrome,and Its Effects on Serum Inflammatory Factors and Vascular Endothelial Function

作　　者：杨志 宋功如 许起琴 吴安源 YANG Zhi;SONG Gong-ru;XU Qi-qin;WU An-yuan(Department of TCM,The Eighth People's Hospital of Hefei,Hefei Anhui 238000)

机构地区：[1]合肥市第八人民医院中医科,安徽合肥238000

出　　处：《世界中西医结合杂志》2024年第8期1657-1663,共7页World Journal of Integrated Traditional and Western Medicine

基　　金：2022年度合肥市卫生健康应用医学研究项目(Hwk2022yb036);2022年安徽省卫生计生委科研计划项目(2022Qk043)。

摘　　要：目的探讨桑芪滋阴补肾汤辅助治疗阴虚阳亢型高血压颈动脉硬化患者的临床疗效及对其血清炎性因子和血管内皮功能的影响。方法选取2019年7月—2021年12月期间合肥市第八人民医院收治的96例阴虚阳亢证高血压颈动脉硬化患者,采用随机数字表法分为对照组和治疗组,每组各48例。对照组给予阿托伐他汀联合苯磺酸左旋氨氯地平治疗,治疗组在对照组基础上联合桑芪滋阴补肾汤治疗。治疗3个月后,观察比较两组患者临床疗效,治疗前后中医证候积分、血清炎性因子[超敏C-反应蛋白(hypersensitive C-reactive protein,hs-CRP)、白细胞介素-6(Interleukin-6,IL-6)、白细胞介素-10(Interleukin-10,IL-10)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)]、血管内皮功能[内皮素-1(Endothelin-1,ET-1)、一氧化氮(Nitric oxide,NO)、血栓素2(Thromboxane B2,TXB2)、血管紧张素Ⅱ(Angiotensin II,AngⅡ)]、血压血脂[收缩压(Systolic blood pressure,SBP)、舒张压(Diastolic blood pressure,DBP)、三酰甘油(Triglyceride,TG)、总胆固醇(Total cholesterol,TC)、低密度脂蛋白(Low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白(High density lipoprotein cholesterol,HDL-C)]、斑块相关指标[颈动脉内膜中层厚度(Intima-media thickness,IMT)、斑块面积、斑块数目]。结果治疗后两组患者眩晕、头痛、腰酸膝软、五心烦热、心悸、失眠、耳鸣、健忘评分及中医证候总积分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组眩晕、头痛、腰酸膝软、五心烦热、心悸、失眠、耳鸣、健忘评分及中医证候总积分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清hs-CRP、IL-6、TNF-α水平均较治疗前降低,IL-10水平均较治疗前升高,差异有统计学意义(P<0.05);且治疗组血清hs-CRP、IL-6、TNF-α水平均明显低于对照组,IL-10明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组�Objective To study the clinical efficacy of Sangqi Ziyin Bushen decoction as an adjunct therapy for hypertensive patients with carotid arteriosclerosis characterized by Yin deficiency and Yang hyperactivity syndrome,and its effects on serum inflammatory factors and vascular endothelial function.Methods 96 hypertensive patients with carotid atherosclerosis of the Yin deficiency and Yang hyperactivity type were admitted at The Eighth People's Hospital of Hefei between July 2019 and December 2021.They were selected and randomly divided into a control group and a treatment group,with 48 cases in each group.The control group received a combination of atorvastatin and levamlodipine besylate,while the treatment group received Sangqi Ziyin Bushen decoction in addition to the control group's treatment.After 3 months of treatment,clinical efficacy was observed and compared between the two groups.Traditional Chinese medicine(TCM)syndrome scores,serum inflammatory factors[hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)],vascular endothelial function[endothelin-1(ET-1),nitric oxide(NO),thromboxane B2(TXB2),angiotensin II(AngII)],blood pressure and lipids levels[systolic blood pressure(SBP),diastolic blood pressure(DBP),triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)],and plaque-related indexes[carotid intima-media thickness(IMT),plaque area,plaque number]were assessed before and after treatment.Results After treatment,scores for dizziness,headache,lower back,and knee softness,five heart fever,palpitations,insomnia,tinnitus,forgetfulness,as well as total TCM syndrome scores,were all significantly reduced in both groups compared before treatment levels,with statistically significant differences(P<0.05);the treatment group showed significantly lower scores in these symptoms and total TCM syndrome scores compared to the control group,with statistically significant differences(P<0.05).

关 键 词：高血压 颈动脉粥样硬化 阴虚阳亢 桑芪滋阴补肾汤 炎性因子 血管内皮功能 

分 类 号：R544.1[医药卫生—心血管疾病] R543.12[医药卫生—内科学]