世界中医药

作者	单位
王春华高怡陈建芝李春禹王长志范洪亮	1 河北三河市燕郊人民医院，三河，065201； 2 河北联合大学中医学院，唐山，063009； 3 北京市通州区中西医结合骨伤医院，北京，101100

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中文摘要:

目的:观察辨证论治联合泽泻汤加味方对高血压病患者各单项症状的影响，明确其适应证型及原因。方法:入选原发性高血压病患者140例，随机分为2组，一组给予辨证论治方，另一组给予辨证论治方联合泽泻汤加味方，口服治疗28天，观测第0天与第28天2组同一证型总体证候积分与各单项症状积分变化。结果:2组相同证型之间总积分比较发现，肝火亢盛证无统计学意义（P>005），其余3种证型（阴虚阳亢证、痰湿壅盛证、阴阳两虚证）均有统计学意义（P<001），均以治疗组证候积分下降明显。2组同一证型中各单项症状积分比较发现，肝火亢盛证各单项症状改善各不相同，而阴虚阳亢证、痰湿壅盛证、阴阳两虚证中单项症状积分均下降并以治疗组更明显，但均无统计学意义（P>005）。结论:辨证论治联合泽泻汤加味方较单纯辨证论治对于肝阳上亢证无意义，对于阴虚阳亢证、痰湿壅盛证、阴阳两虚证均具有较好的改善中医总体证候作用，且这种作用是通过整体改善，而并非针对某个单项症的改善实现的。

English Summary:

To observe syndrome differentiation and treatment combined with Zixie modified decoction on individual symptoms of hypertension, in order to identify indications of the combined treatment. Methods: Patients with primary hypertension (n=140) were randomized to two groups, one group was given treatment based on syndrome differentiation, the other group was given modified Zixie decoction in addition. We observed overall symptom scores and individual symptom scores in patients of the same type on day 0 and day 28. Results: Comparison of total scores of a same type between groups: Overabundant liver fire was no significantly different (P>005), vacuity pattern, phlegm dampness card, yin and yang deficiency were significantly different (P<001),and observation group was superior to control group. Comparison of individual symptom scores: both groups relieved individual symptoms for type of Overabundant liver fire; observation group was not statistically better in other 3 types (P> 005). Conclusion: Compared with syndrome differentiation treatment alone, the combined treatment showed advantage for treatment of vacuity pattern, phlegm dampness, Yin and Yang deficiency, in terms of relief of overall symptoms. Regarding Overabundant liver fire, the difference is not significantly better.

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