清眩活络降压汤治疗痰瘀互结型H型高血压的临床疗效及对血管内皮功能的影响  

The Clinical Efficacy of Qingxuan Huoluo Jiangya Decoction in the Treatment of H-Type Hypertension With Phlegm Blood Stasis and Its Impact on Vascular Endothelial Function

作　　者：曹丽娟 潘志松 王皖琪 宁微 李滕 杨威 CAO Lijuan;PAN Zhisong;WANG Wanqi;NING Wei;LI Teng;YANG Wei(Department of Cardiology,Hospital of Traditional Chinese Medicine of Qiqihar,Qiqihar Heilongjiang 161000,China)

机构地区：[1]齐齐哈尔市中医医院心内科,黑龙江齐齐哈尔161000

出　　处：《中国卫生标准管理》2024年第21期164-168,共5页China Health Standard Management

基　　金：国家自然科学基金青年科学基金项目(82104962);黑龙江省中医药学会青年人才托举工程项目(2022-QNRC1-28);齐齐哈尔市科技计划创新激励项目(CSFGG-2023181)。

摘　　要：目的探讨清眩活络降压汤治疗痰瘀互结型H型高血压的临床疗效及对血管内皮功能的影响。方法选取2023年2月—2024年2月在齐齐哈尔市中医院心血管内科就诊的H型高血压患者80例,随机分为治疗组和对照组,各40例。对照组仅接受马来酸依那普利片治疗,1次/d,10 mg/次,持续8周;而治疗组在此基础上加用清眩活络降压汤,1剂/d,早晚饭后半小时服用,持续8周。研究观察指标包括血压、血管内皮损伤指标、颈动脉内-中膜厚度(intima-media thickness,IMT)、血清同型半胱氨酸(homocysteine,Hcy)水平及血浆可溶性细胞间黏附分子-1(soluble intercellular adhesion molecule-1,sICAM-1)水平以及不良反应等。结果治疗组总有效率为95.00%,高于对照组的80.00%,差异有统计学意义(P<0.05)。2组治疗后的收缩压和舒张压均显著低于治疗前,且治疗组收缩压(110.73±8.11)mmHg,和舒张压(79.25±5.03)mmHg,均优于对照组(134.55±8.25)mmHg、(97.56±5.23)mmHg,差异有统计学意义(P<0.05)。2组血管内皮损伤指标一氧化氮(nitric oxide,NO)和血管内皮素(endothelin-1,ET-1)水平在治疗后有改善,且治疗组NO(78.98±3.58)mol/L和ET-1水平(51.22±4.56)μg/L改善程度大于对照组(71.55±4.21)mol/L、(60.32±8.27)μg/L,差异有统计学意义(P<0.05)。2组IMT、血浆sICAM-1和血清Hcy水平治疗后均有所降低,治疗组IMT(1.02±0.08)mm、血浆sICAM-1(7.21±1.01)μmol/L和血清Hcy水平(321.52±22.56)g/L降低幅度大于对照组(1.13±0.11)mm、(9.02±1.02)μmol/L、(370.12±25.35)g/L,差异有统计学意义(P<0.05)。结论清眩活络降压汤在改善痰瘀互结型H型高血压患者的临床症状、降低血压、改善血管内皮功能等方面显示出良好的疗效,且安全性较好。Objective To explore the clinical efficacy of Qingxuan Huoluo Jiangya Decoction in the treatment of H-type hypertension with phlegm stasis syndrome and its impact on endothelial function.Methods A total of patients with H-type hypertension who visited the department of cardiovascular,Hospital of Traditional Chinese Medicine of Qiqihar from February 2023 to February 2024 were randomly divided into a treatment group and a control group,with 40 patients in each group.The control group only received treatment with enalapril maleate tablets once a day,10 mg/time,for 8 weeks.On this basis,the treatment group added Qingxuan Huoluo Jiangya Tang,1 dose/day,taken half an hour after breakfast and dinner,for 8 weeks.Research observation indicators include blood pressure,endothelial injury indicators,carotid intima-media thickness(IMT),serum homocysteine(Hcy)levels,plasma soluble intercellular adhesion molecule-1(sICAM-1)levels,and adverse reactions.Results The total effective rate of the treatment group was 95.00%,which was higher than the control group's 80.00%,with statistical significance(P<0.05).The systolic and diastolic blood pressure in both groups after treatment were significantly lower than before treatment,and the systolic blood pressure(110.73±8.11)mmHg and diastolic blood pressure(79.25±5.03)mmHg in the treatment group were better than those in the control group(134.55±8.25)mmHg and(97.56±5.23)mmHg,with statistical significance(P<0.05).The levels of nitric oxide(NO)and endothelin(ET-1),two indicators of vascular endothelial injury,improved after treatment,and the improvement of NO(78.98±3.58)mol/L and ET-1 levels(51.22±4.56)μg/L in the treatment group was greater than that in the control group(71.55±4.21)mol/L and(60.32±8.27)μg/L,with statistical significance(P<0.05).Both groups showed a decrease in IMT,plasma sICAM-1,and serum Hcy levels after treatment.The treatment group had a greater decrease in IMT(1.02±0.08)mm,plasma sICAM-1(7.21±1.01)μmol/L,and serum Hcy levels(321.52±22.56)g/L than the cont

关 键 词：清眩活络降压汤 痰瘀互结型 H型高血压 血管内皮功能 颈动脉内-中膜厚度 临床研究 

分 类 号：R259[医药卫生—中西医结合]