中西医结合治疗虚证高血压临床观察

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目的:观察中药联合马来酸依那普利片和(或)硝苯地平缓释片治疗原发性高血压主证属阴阳两虚者的疗效。方法:将80例患者随机分为2组各40例,治疗组给予中药方(仙茅、淫羊藿、巴戟天、熟地黄、旱莲草、益母草、山茱萸和女贞子)治疗,西药选用马来酸依那普利片和(或)硝苯地平缓释片治疗,对照组单纯采用马来酸依那普利片和(或)硝苯地平缓释片治疗。观察2组的降压疗效和中医证候疗效,并通过检测患者治疗前后的尿微量白蛋白(MA)以考察药物对肾功能的保护作用。结果:降压疗效总有效率治疗组95.0%,对照组90.0%,2组总有效率比较,差异无显著性意义(P>0.05)。2组治疗后收缩压、舒张压均显著下降,与治疗前比较,差异均有显著性意义(P<0.05)。治疗组中医证候疗效均优于对照组(P<0.01)。2组治疗前后尿MA的阳性率均明显降低,不良反应轻微。结论:中药配合西药治疗虚证原发性高血压既可降压又可改善临床症状,还可保护患者的肾功能。 Objective: To observe the curative effect of traditional Chinese medicine combined with enalapril maleate and (or) nifedipine sustained-release tablets in the treatment of essential hypertension patients with yin and yang deficiency. Methods: Eighty patients were randomly divided into two groups (n = 40). The treatment group was given traditional Chinese medicine (Curculigo, Epimedium, Morinda officinalis, Rehmannia, Eclipta, Motherwort, Cornus and Fructus Ligustri Lucidi) The enalapril maleate tablets and / or nifedipine sustained-release tablets were used. The control group was treated with enalapril maleate and / or nifedipine sustained-release tablets. The antihypertensive effect and TCM syndrome curative effect of the two groups were observed. The urine microalbumin (MA) before and after treatment was measured to examine the protective effect of the drug on renal function. Results: The total effective rate of antihypertensive effect was 95.0% in the treatment group and 90.0% in the control group. There was no significant difference in the total effective rate between the two groups (P> 0.05). After treatment, systolic and diastolic blood pressure decreased significantly in both groups (P <0.05), compared with those before treatment. The curative effect of TCM syndrome in the treatment group was better than that in the control group (P <0.01). The positive rates of urinary MA before and after treatment in both groups were significantly lower, with mild adverse reactions. Conclusion: Traditional Chinese medicine combined with western medicine can reduce blood pressure and improve clinical symptoms of essential hypertension, but also protect the renal function of patients.
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