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[目的]观察丹栀逍遥散联合氟西汀、硝苯地平治疗肝气郁结老年高血压合并抑郁疗效。[方法]使用随机平行对照方法,将80例住院及门诊患者按就诊顺序编号方法简单随机分为两组。对照组40例氟西汀20mg/次,1次/d,口服;硝苯地平10mg/次,1次/d,口服。治疗组40例丹栀逍遥散:生牡蛎、夜交藤各30g,白芍、柴胡各15g,茯苓12g,牡丹皮、栀子各10g,生姜9g,薄荷、灸甘草各6g;心神不宁加远志、酸枣仁;气虚加党参、黄芪;汗多加大枣;失眠加小麦、五味子;淤血去牡丹皮、栀子,加枳壳、川芎,水煎500mL,2次/d;氟西汀、硝苯地平治疗同对照组。连续治疗4周为1疗程。观测临床症状、血压、中医症候积分、抑郁评分、不良反应。治疗1疗程(4周),判定疗效。[结果]治疗组显效21例,有效17例,无效2例,总有效率95.00%;对照组显效18例,有效14例,无效8例,总有效率80.00%;治疗组疗效优于对照组(P<0.05)。舒张压、收缩压、中医症状积分、抑郁评分两组均明显改善(P<0.01,P<0.05),治疗组改善优于对照组对照组(P<0.05,P<0.01)。[结论]丹栀逍遥散联合氟西汀、硝苯地平治疗肝气郁结老年高血压合并抑郁,疗效满意,无严重不良反应,值得推广。
[Objective] To observe the therapeutic effect of Danzhixiaoyao powder combined with fluoxetine and nifedipine on senile hypertension complicated with depression of liver qi stagnation. [Method] Using randomized parallel control method, 80 inpatients and outpatients were randomly divided into two groups according to the sequence number of visiting doctor. Control group, 40 cases of fluoxetine 20mg / time, 1 / d, oral; nifedipine 10mg / time, 1 / d, orally. Treatment group, 40 cases of Dan Zhi Xiaoyao San: raw oysters, night lotus each 30g, white peony, Bupleurum each 15g, Poria 12g, tree peony bark, Gardenia each 10g, ginger 9g, mint, licorice each 6g; Fructus plus wheat, Schisandra; congestion go moutan, gardenia, plus Citrus aurantium, Chuanxiong, decoction 500mL, 2 times / d; fluoxetine, Nifedipine treatment with the control group. Continuous treatment for 4 weeks for a course of treatment. Observation of clinical symptoms, blood pressure, TCM symptom score, depression score, adverse reactions. Treatment 1 course of treatment (4 weeks), to determine the efficacy. [Results] In the treatment group, 21 cases were markedly effective, 17 cases were effective, 2 cases were ineffective and the total effective rate was 95.00%. In the control group, 18 cases were markedly effective, 14 cases were effective, 8 cases were ineffective and the total effective rate was 80.00%. The treatment group was superior to the control group (P <0.05). The diastolic blood pressure, systolic blood pressure, TCM symptom score and depression score were significantly improved in both groups (P <0.01, P <0.05). The treatment group improved better than the control group (P <0.05, P <0.01). [Conclusion] Danzhi Xiaoyao powder combined with fluoxetine and nifedipine in the treatment of senile hypertension and depression with liver-qi stagnation has satisfactory curative effect and no serious adverse reactions, which deserves promotion.