世界中医药

目的:观察调压活络方治疗H型高血压的疗效,初步探讨其机制。方法:将2015年3月至2016年2月就治的H型高血压患者94例采用随机数字表法分为2组,每组47例,对照组给予依叶片口服,1片/d;治疗组给予依叶片＋调压活络方治疗,1剂/d,持续治疗2个疗程。观察2组治疗效果,检测血管活性物质、血液流变学、氧化应激指标及肾素-血管紧张素Ⅱ-醛固酮(Renin AngiotensinⅡ Aldosterone System，RAAS)系统变化。结果:1)治疗组治疗后除了气短、乏力、善忘积分外,其余症候积分及总分下降幅度均大于对照组,差异有统计学意义(P<0.05);2)治疗后治疗组日间收缩压、舒张压及晚间收缩压、舒张压下降幅度大于对照组,差异有统计学意义(P<0.05);2组治疗后高同型半胱氨酸(Homocysteine,Hcy)浓度比较差异无统计学意义(P>0.05);3)治疗组治疗后RA、AngⅡ低于对照,差异有统计学意义(P<0.05);4)2组治疗后丙二醛(Malondialdehyde,MDA)、髓过氧化物酶(myeloperoxidase,MPO)、氧化物歧化酶(Superoxide Dismutase,SOD)与治疗前比较差异无统计学意义(P>0.05);5)治疗组治疗后前列环素(Prostacyclin,PGI2)低于对照组,而血栓素(Thromboxane A2,TXA2)高于对照组,差异有统计学意义(P<0.05);6)治疗组治疗后血小板活化因子、血小板凝聚率、全血黏度高切均低于对照组,差异有统计学意义(P<0.05)。结论:调压活络方可有效控制H型高血压患者血压,改善症状,值得临床推广适用;其机制可能与调节RAAS系统、保护内皮细胞及减少血液黏稠度有关。

English Summary:

To observe the effect and mechanism of Hypertension Regulating and Collaterals Activating Prescription in the treatment of H-hypertension. Methods:A total of 94 patients with H-hypertension in March 2015 to February 2016, were divided into two groups by random number table method, 47 cases in each group, the control group was treated with blade, 1 piece/d; while the study group treated with blade + Hypertension Regulating and Collaterals Activating Prescription, once a day, treatment lasted for two courses. The effect, vascular active substances, blood rheology, oxidative stress indicators and renin-angiotensin Ⅱ-aldosterone system (RAAS) changes were observed. Results:1) After the treatment, the study group had significantly better results in symptoms score and total scores than the control group expect for shortness of breath, fatigue, forgetfulness (P<0.05); 2) After the treatment, the day and late systolic pressure, diastolic blood pressure and systolic blood pressure, diastolic blood pressure of the study group met a significantly greater drop than the control group (P<0.05); Hcy concentration had no statistical significance (P>0.05); 3) RA, Ang Ⅱ in the study group were significantly lower than the control group (P<0.05); 4) There were no statistically significant differences in MDA, MPO, SOD between two groups (P>0.05); 5) After treatment, PGI2 in the study group was lower than the control group， and TXA2 was higher, the differences were statistically significant (P<0.05); 6) platelet activating factors, platelet aggregation rate, whole blood viscosity, high shear in the study group were lower than that in the control group, the differences were statistically significant (P<0.05). Conclusion:Hypertension Regulating and Collaterals Activating Prescription can effectively control the blood pressure, and improve symptoms in the treatment of H-hypertension, which is worthy of clinical promotion. The mechanism may be related to regulating RAAS system, protecting endothelial cells and reducing blood viscosity.

查看全文查看/发表评论下载PDF阅读器