基于营卫理论探讨益气活血通脉汤治疗气虚血瘀型反杓型高血压的临床研究  

Clinical Study of Yiqi Huoxue Tongmai Decoction in the Treatment of Reverse Dipper Hypertension with Qi Deficiency and Blood Stasis Based on Ying-wei Theory

作　　者：唐娜娜[1] 徐媛媛 缪慧慧 陈抒鹏 刘中勇[1] TANG Nana;XU Yuanyuan;MIAO Huihui;CHEN Shupeng;LIU Zhongyong(Department of Cardiology,Affiliated Hospital of Jiangxi University of Chinese Medicine/Branch Center of National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine,Nanchang 330006,China;Graduate School of Jiangxi University of Chinese Medicine,Nanchang 330004,China)

机构地区：[1]江西中医药大学附属医院心血管科/国家中医心血管病临床医学研究中心分中心,南昌330006 [2]江西中医药大学研究生院,南昌330004

出　　处：《江西中医药大学学报》2025年第2期32-36,40,共6页Journal of Jiangxi University of Chinese Medicine

基　　金：全国名老中医药专家传承工作室建设项目(国中药人教函[2022]75号);江西省中医药中青年骨干人才培养计划项目(赣中医药科教字[2021]4号);江西省中医药科技计划重点项目(2021Z013);江西省教育厅科技计划项目(GJJ211216)。

摘　　要：目的:探讨基于营卫理论指导下应用益气活血通脉汤治疗气虚血瘀型反杓型高血压的疗效。方法:选取2022年1—2月就诊于江西中医药大学附属医院心血管科的气虚血瘀型反杓型高血压患者60例,随机分为对照组和观察组,各30例。对照组给予苯磺酸氨氯地平片治疗,观察组在对照组基础上给予益气活血通脉汤治疗,疗程为12周。观察2组患者临床疗效,治疗前后中医证候积分、血脂水平[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、动态血压水平[24 h平均收缩压(24 h SBP)、24 h平均舒张压(24 h DBP)、日间平均收缩压(dSBP)、日间平均舒张压(dDBP)、夜间平均收缩压(n SBP)、夜间平均舒张压(n DBP)、夜间收缩压下降率(SBPF)、夜间舒张压下降率(DBPF)、收缩压负荷(SBPL)、舒张压负荷(DBPL)、晨峰血压(MBPS)、脉压差(PP)]、血压昼夜节律,并记录不良反应。结果:治疗后,观察组总有效率(96.67%)高于对照组(73.33%)(P<0.05);2组患者治疗后中医证候积分、血脂水平均较治疗前下降(P<0.05,P<0.01),且观察组中医证候积分及TC、TG水平均低于对照组(P<0.05);2组患者治疗后各动态血压水平均较治疗前降低,且观察组24 h SBP、n SBP、24 h DBP、dDBP、24 h SBPL、d SBPL、nSBPL、24 h DBPL、dDBPL、MBPS均低于对照组(P<0.05);治疗后观察组反杓型血压昼夜节律逆转率高于对照组(P<0.05);治疗期间2组患者的不良反应无显著差异。结论:营卫理论指导下的益气活血通脉汤能够缓解气虚血瘀型反杓型高血压患者临床症状,降低患者血压,恢复血压节律。Objective:To investigTo investigate the therapeutic effect of Yiqi Huoxue Tongmai Decoction on reverse dipper hypertension with Qi deficiency and blood stasis guided by Ying-wei Theory.Methods:Sixty patients with qi deficiency and blood stasis type reverse dipper hypertension who were treated in the department of cardiology of the affiliated hospital of Jiangxi university of Chinese medicine from January to February 2022 were selected and randomly divided into a control group and an observation group,with 30 cases in each group.The control group were treated with amlodipine besylate tablets,while the observation group were treated with Yiqi Huoxue Tongmai Decoction on the basis of the control group for 12 weeks.Observe the clinical efficacy of 2 groups of patients,TCM syndrome score and blood lipid levels[total cholesterol(TC),triglycerides(TG),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C)],the ambulatory blood pressure level[24-hour mean systolic blood pressure(24 h SBP),24-hour mean diastolic blood pressure(24 h DBP),daytime mean systolic blood pressure(dSBP),daytime mean diastolic blood pressure(dDBP),nighttime mean systolic blood pressure(nSBP),nighttime mean diastolic blood pressure(nDBP),nocturnal systolic blood pressure drop rate(SBPF),nocturnal diastolic blood pressure drop rate(DBPF),systolic pressure load(SBPL),diastolic pressure load(DBPL),morning peak blood pressure(MBPS),pulse pressure difference(PP),blood pressure circadian rhythm,and recorded adverse reactions before and after treatment were compared between the two groups.Results:After treatment,the total effective rate in the observation group(96.67%)was higher than that in the control group(73.33%)(P<0.05).Both groups showed reduced TCM syndrome scores and improved lipid profiles compared to baseline(P<0.05,P<0.01),with the observation group exhibiting lower TCM scores and TC/TG levels than the control group(P<0.05).Ambulatory blood pressure parameters decreased in both groups post-treatment,and the observation group demonstrate

关 键 词：营卫理论 益气活血通脉汤 气虚血瘀型 反杓型高血压 血压昼夜节律 

分 类 号：R259[医药卫生—中西医结合]