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目的探讨缬沙坦联合氨氯地平治疗社区高龄原发性高血压合并糖尿病患者的临床效果及对肾功能的影响。方法选取93例广东深圳市福永人民医院幸福花园社康中心2015年1月—2016年10月收治的高龄(≥60岁)原发性高血压合并糖尿病患者作为研究对象,根据随机数表法分为对照组46例和观察组47例。对照组应用缬沙坦治疗,观察组应用缬沙坦联合氨氯地平治疗,两组患者均连续治疗2个月,比较两组患者的临床疗效、血压、血糖、尿酸水平及不良反应发生率。结果观察组患者治疗总有效率为95.74%,明显高于对照组患者的80.43%,差异有统计学意义(P<0.05)。在舒张压、收缩压、空腹血糖、餐后2 h血糖、尿酸方面,观察组患者治疗后的水平均低于对照组患者,差异有统计学意义(P<0.05)。观察组不良反应发生率为6.38%,低于对照组的10.87%,差异无统计学意义(P>0.05)。结论在原发性高血压合并糖尿病治疗中,缬沙坦联合氨氯地平的治疗效果明显优于单一缬沙坦治疗,具有降糖、降压的作用,且不良反应发生较少。
Objective To investigate the clinical effects of valsartan combined with amlodipine in the treatment of elderly patients with essential hypertension complicated with diabetes mellitus and its effect on renal function. Methods A total of 93 elderly patients (≥60 years old) with primary hypertension and diabetes mellitus admitted from January 2015 to October 2016 in Futian Garden Community Health Center of Fuyong People’s Hospital of Guangdong Province were selected as subjects. According to the random number table 46 cases in control group and 47 cases in observation group. The control group was treated with valsartan. The observation group was treated with valsartan combined with amlodipine. The patients in both groups were treated continuously for 2 months. The clinical efficacy, blood pressure, blood glucose, uric acid levels and the incidence of adverse reactions were compared between the two groups. Results The total effective rate of observation group was 95.74%, which was significantly higher than that of the control group (80.43%), the difference was statistically significant (P <0.05). In the diastolic blood pressure, systolic blood pressure, fasting blood glucose, 2 h postprandial blood glucose, uric acid, the observation group patients after treatment levels were lower than the control group, the difference was statistically significant (P <0.05). The incidence of adverse reactions in the observation group was 6.38%, which was lower than that in the control group (10.87%), with no significant difference (P> 0.05). Conclusion Valsartan combined with amlodipine is superior to single valsartan in the treatment of patients with essential hypertension and diabetes mellitus. It has the effect of lowering blood pressure and lowering blood pressure, and has fewer adverse reactions.