作 者 ：钟广伟,罗艳红,相玲丽,谢勇,谢启应,李云辉,张臣
期 刊 ：中国中药杂志 2010年 35卷 6期 页码：776.
Keywords:essential hypertension, calming liver and restraining the Yang formula, mild or moderate degree, clinical study,
摘 要 ：目的: 观察平肝潜阳方对早、中期原发性高血压病患者(肝阳上亢证)的降压效果,并探讨其治疗高血压病的疗效机制。 方法 :采用分层随机设计的方法将348例符合纳入标准的患者分为治疗组和对照组各174例,治疗12周。观察2组治疗前后的相关症状积分、24 h 动态血压(ABMP)、心率、生活质量量表评分、血脂指标改善,评价中药治疗高血压病的临床疗效,同时两组各随机抽取40例检测治疗前后血清血管紧张素Ⅱ(AngⅡ)、超敏C反应蛋白(Hs-CRP)、降钙素基因相关肽(CGRP)水平。 结果 :治疗后,治疗组可显著降低血压变异性和夜间血压下降率,且夜间血压下降率优于对照组(P<0.05),血压变异性和总有效率也与对照组比较,无差异显著性;治疗组在改善眩晕、腰膝酸软、心烦、口干口苦、提高生活质量、降低心率、总胆固醇(TC)、甘油三脂(TG)和高密度脂蛋白(HDL-C)方面明显优于对照组(P<0.05)。两组治疗后血清AngⅡ和Hs-CRP水平下降,而血清CGRP水平上升,与治疗前比较差异有显著性(P<0.01);两组治疗后比较,无显著性差异。 结论 :平肝潜阳方对早、中期原发性高血压病患者具有较好的降压疗效,能够改善临床症状、提高生活质量、调节血脂代谢,其作用机制可能与减轻炎症反应及抑制肾素-血管紧张素-醛固酮系统(RAAS)活性有关。
Abstract:Objective : To observe the therapeutic effect of calming the liver and restraining the Yang formula in treating patients with mild or moderate degree of essential hypertension (syndrome of hyperactivity of liver-Yang), and to eaplore its mechanism in lowering blood pressure. Method : The 348 patients with EH of stage Ⅰ, Ⅱ were randomly divided into two groups, the 174 patients in the treated group were treated with the calming the liver and restraining the Yang formula, and the 174 patients in the control group were treated with amlodipine. The treatment course for them all was 12 weeks. The related clincial symptoms score and quality of life score estimated before and after treatment at 4th week, 8th week and 12th week were observed. Before and after treatment, the ambulatory blood pressure (AMBP), heart rate, blood lipid, serum livels of high-sensitivity C-reactive protein(Hs-CRP), Angiotensin-Ⅱ(AngⅡ) and calcitonin gene-related peptide(CGRP) were measured respectively in 40 patients of the treared group and 40 patients of the control group. Result : After treatment, the treatment in the treated group showed an effect better than that in the control group in terms of nigh-time blood pressure reducing rate(P<0.05). The reducing blood pressure variability and total effective rate in the treated group were no significant than that in the control group. In respect of reducing symptomatic scores on dizzy, soreness and weakness of the waist and knees, disturbed and dry and bitter of mouth, ameliorating quality of life score, decreasing the levels of heart rate, total cholesterol(TC), triglyceride(TG), high-density lipoprotein cholesterol(HDL-C) in the treated group were showing marked improvement as compared with that in the control group (P<0.05 or P<0.01). The improvement in the level of AngⅡ, Hs-CRP and CGRP before treatment in two groups were more significant than that after treatment(P<0.05). However There were no difference in after treatment between the treated group and the control group. Conclusion : The calming the liver and restraining the Yang formula shows favorable efficacy in lowering blood pressure on the patients with mild or moderate degree of essential hypertension. It can reduce the clincial symptoms, improve the quality of life, regulate blood lipid metabolism. Its mechanism may be related to the functional relieving inflammatory reaction and inhibition the activity of renin-angiotensin- aldosterone system(RAAS).