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目的探讨早晨和晚上服用复方利血平氨苯喋啶片治疗6个月对非杓型原发性高血压患者血压节律和24 h动态血压的影响。方法本研究采用多中心、开放性研究,选择符合入组条件的非杓型原发性高血压患者461例,随机分为早晨服药组(n=230)和晚上服药组(n=230),分别给予复方利血平氨苯喋啶片治疗,1片/次,1次/d,连续治疗6个月。治疗结束时测量24 h动态血压。结果两组治疗前和治疗后各时间点收缩压和舒张压水平比较,差异均有统计学意义(P<0.05);其中两组治疗后各时间点收缩压和舒张压水平均较治疗前明显降低,差异有统计学意义(P<0.05)。治疗后两组血压的达标率分别为91.8%(202/220)和91.5%(206/225)。24 h动态血压监测表明,治疗后两组24 h平均收缩压/舒张压、白天平均收缩压/舒张压、夜间平均收缩压/舒张压水平组间比较,差异均无统计学意义(P>0.05),各组治疗后各时间点血压水平均较治疗前明显降低,差异有统计学意义(P<0.05)。治疗后共190例患者血压昼夜节律由非杓型改变为杓型,早晨服药组104例,晚上服药组86例,两组血压昼夜节律转变率间差异无统计学意义(P>0.05)。结论早晨和晚上服用复方利血平氨苯喋啶片均能够明显降低非杓型原发性高血压患者的诊室偶测血压和动态血压;能显著降低夜间血压水平,纠正异常血压节律。
Objective To investigate the effect of taking compound reserpine and triamcinolone acetonide tablets on blood pressure rhythm and 24-hour ambulatory blood pressure in patients with non-dipper essential hypertension in the morning and evening. METHODS: A multicenter, open-label study was conducted in 461 non-dipper essential hypertension patients eligible for inclusion in the study. Patients were randomized into morning and evening groups (n = 230 and n = 230) Patients were given compound reserpine triamterene tablets treatment, 1 / time, 1 / d, continuous treatment for 6 months. 24 h ambulatory blood pressure measurement at the end of treatment. Results Before and after treatment, systolic blood pressure and diastolic blood pressure were significantly different between the two groups (P <0.05). The systolic blood pressure and diastolic blood pressure of the two groups after treatment were significantly higher than those before treatment Reduce, the difference was statistically significant (P <0.05). After treatment, the compliance rates of blood pressure were 91.8% (202/220) and 91.5% (206/225) respectively. 24 h ambulatory blood pressure monitoring showed that there was no significant difference in 24 h average systolic blood pressure / diastolic blood pressure, daytime systolic blood pressure / diastolic blood pressure, and nighttime average systolic blood pressure / diastolic blood pressure in the two groups after treatment (P> 0.05 ). The blood pressure of each group after treatment was significantly lower than that before treatment, the difference was statistically significant (P <0.05). Blood pressure circadian rhythms in 190 patients changed from non-dippers to dippers, 104 in the morning and 86 in the evening. There were no significant differences in the circadian rhythm of blood pressure between the two groups (P> 0.05). Conclusion Both morning and evening doses of compound reserpine and triamcinolone acetonide can significantly reduce the occasional blood pressure and ambulatory blood pressure in non-dipper patients with essential diphtheria, significantly reduce the nighttime blood pressure and correct abnormal blood pressure rhythm.