耳尖放血联合天麻钩藤饮治疗肝阳上亢型高血压临床研究  

Clinical Study on Bloodletting at the Auricular Apex Combined with Gastrodia and Uncaria Decoction in the Treatment of Hypertension with Syndrome of Hyperactivity of Liver Yang

作　　者：胡旭红 孙文博[1] 刘艳萍 曾霞 丁艳丽 孙彦琴[1] HU Xuhong;SUN Wenbo;LIU Yanping;ZENG Xia;DING Yanli;SUN Yanqin(The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou,Henan,China,450001)

机构地区：[1]河南中医药大学第一附属医院,河南郑州450001

出　　处：《河南中医》2025年第4期610-616,共7页Henan Traditional Chinese Medicine

基　　金：河南省中医药科学研究专项项目(2023ZXZX1008)。

摘　　要：目的:观察耳尖放血联合天麻钩藤饮治疗肝阳上亢型高血压的临床疗效。方法:选取2022年1月至2024年1月河南中医药大学第一附属医院收治的150例肝阳上亢型高血压患者为研究对象,按照随机数字表法分为对照组和观察组,每组各75例。两组患者均给予硝苯地平控释片,对照组给予天麻钩藤饮,观察组在对照组治疗的基础上联合耳尖放血治疗。比较两组患者临床疗效、不良反应发生情况及治疗前后中医证候积分、血压情况、生活质量评分、肾功能指标[尿微量白蛋白(microalbuminuria,MAU)、尿肌酐清除率、尿微量白蛋白与肌酐比值(albumin creatinine ratio,ACR)]。结果:治疗后,观察组中医证候积分分别为:头晕目眩(1.15±0.13)分、面红目赤(1.31±0.16)分、急躁易怒(1.50±0.20)分、口苦口干(1.39±0.27)分,总分(5.31±0.64)分,均低于本组治疗前及对照组治疗后,差异具有统计学意义(P<0.05)。观察组有效率为98.67%,高于对照组的76.00%,差异具有统计学意义(P<0.05)。治疗后,观察组患者收缩压(136.58±11.26) mm Hg,舒张压(85.91±5.40) mm Hg,24 h收缩压(136.67±9.46) mm Hg,24 h舒张压(81.62±5.13) mm Hg,下降幅度均显著高于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组生活质量评分分别为:生理机能(75.79±5.82)分、生理职能(73.18±0.55)分、躯体疼痛(72.42±6.43)分、一般健康状况(59.57±4.59)分、精力(64.58±5.57)分、社会功能(66.48±5.65)分、情感职能(75.85±4.38)分、精神健康(66.82±5.29)分,高于本组治疗前及对照组治疗后,差异具有统计学意义(P<0.05)。治疗后,观察组MAU为(20.56±4.43)μg·g^(-1),尿肌酐清除率为(1.89±0.46) g·24 h^(-1)、ACR为(10.29±2.69),低于本组治疗前及对照组治疗后,差异具有统计学意义(P<0.05)。观察组不良反应发生率为5.33%,低于对照组的18.67%,差异具有统计学意义(P<0.05)。结论:耳尖放血联合天麻钩藤饮治疗肝阳上亢�Objective:To observe the clinical efficacy of bloodletting at the auricular apex combined with Gastrodia and Uncaria Decoction on hypertension with syndrome of hyperactivity of liver yang.Methods:A total of 150 hypertension patients with syndrome of hyperactivity of liver yang admitted to The First Affiliated Hospital of Henan University of Chinese Medicine from January 2022 to January 2024 were selected as the research subjects and randomly divided into the control group and the observation group,with 75 cases in each group.Both groups were first given Nifedipine Sustained-Release Tablets.Then the control group was additionally given Gastrodia and Uncaria Decoction,while the observation group was treated with bloodletting at the auricular apex in addition to the treatment of the control group.The clinical efficacy,adverse reactions,changes in TCM syndrome scores,blood pressure,quality of life scores,and renal function indicators [such as urinary microalbumin(MAU),urinary creatinine clearance rate,albumin creatinine ratio(ACR)] before and after treatment were compared between the two groups.Results:After treatment,the TCM syndrome scores of the observation group were as follows:dizziness(1.15±0.13) points,facial flushing and red eyes(1.31±0.16) points,irritability and anger(1.50±0.20) points,bitter and dry mouth(1.39±0.27) points,and total score(5.31±0.64) points,which were all lower than those before treatment in the same group and after treatment in the control group,and all the differences were statistically significant(P<0.05).The effective rate of the observation group was 98.67%,which was higher than that of the control group(76.00%),and the difference was statistically significant(P<0.05).The systolic blood pressure of the observation group was(136.58±11.26) mm Hg,diastolic blood pressure was(85.91±5.40) mm Hg,24-hour systolic blood pressure was(136.67±9.46) mm Hg,and 24-hour diastolic blood pressure was(81.62±5.13) mm Hg,with a significant decrease compared to the control group,and all the differ

关 键 词：高血压 耳尖放血 天麻钩藤饮 肝阳上亢证 

分 类 号：R259.441[医药卫生—中西医结合]