论文部分内容阅读
目的:观察由不同降压机制组成的小剂量四联复方降压制剂的临床疗效和不良反应,并与常规剂量二联复方降压制剂比较。方法:1～3级原发性高血压病人314例随机分组:Ⅰ组(n=102)服用硝苯地平(10mg)+阿替洛尔(25mg)组成的复方缓释制剂(1号),1片/次,2次/d;Ⅱ组(n=108)服用卡托普利(25mg)+氢氯噻嗪(12.5mg)组成的复方缓释制剂(2号),1片/次,2次/d;Ⅲ组(n=104)服用硝苯地平(5mg)+卡托普利(12.5mg)+阿替洛尔(12.5mg)+氢氯噻嗪(6.25mg)组成的四联复方缓释制剂(3号),1片/次,2次/d。观察治疗前与治疗8周后各组降压达标率、总有效率、偶测血压、24h动态血压及不良反应。结果:Ⅲ组达标率高于Ⅰ组和Ⅱ组(81.55%、64.29%、58.95%,P<0.01)。Ⅲ组总有效率高于Ⅰ组和Ⅱ组(89.32%、74.47%、73.68%,P<0.01)。治疗8周后,Ⅲ组偶测血压低于Ⅰ组和Ⅱ组(P<0.01)。治疗8周后动态血压监测结果,Ⅲ组24h收缩压比Ⅰ组和Ⅱ组低(P<0.05),24h舒张压低于Ⅰ组(P<0.01)和Ⅱ组(P<0.05)。Ⅲ组头昏、头痛、面红、踝部水肿症状的发生率比Ⅰ组少(P<0.05),干咳症状比Ⅱ组少(P<0.01)。而Ⅲ组肝功能、肾功能、电解质、血脂、空腹血糖、血尿酸、血常规与Ⅰ组和Ⅱ组在治疗前后分别比较无统计学意义。结论:小剂量四联复方制剂在临床应用中疗效优于常规剂量二联复方制剂,且不良反应较少。
OBJECTIVE: To observe the clinical efficacy and side effects of low-dose, quadruple-compound antihypertensive agents composed of different antihypertensive mechanisms and compare with conventional antihypertensive agents. Methods: A total of 314 patients with primary hypertension were randomly divided into three groups: group Ⅰ (n = 102), nifedipine (10 mg) and atenolol (25 mg) (N = 108) was treated with captopril (25mg) + hydrochlorothiazide (12.5mg) in a controlled release formulation (n = 2), once daily for 2 times a day, d; group Ⅲ (n = 104) was treated with nifedipine (5mg) + captopril (12.5mg) + atenolol (12.5mg) + hydrochlorothiazide No.), 1 tablet / time, 2 times / d. Observed before treatment and after 8 weeks of treatment, the standard of blood pressure, total effective rate, even measured blood pressure, 24h ambulatory blood pressure and adverse reactions were observed in each group. Results: The compliance rate of group Ⅲ was higher than that of group Ⅰ and Ⅱ (81.55%, 64.29%, 58.95%, P <0.01). The total effective rate of group Ⅲ was higher than that of group Ⅰ and Ⅱ (89.32%, 74.47%, 73.68%, P <0.01). After 8 weeks of treatment, the measured blood pressure in group Ⅲ was lower than that in group Ⅰ and Ⅱ (P <0.01). After 8 weeks of treatment, ambulatory blood pressure monitoring results showed that systolic blood pressure of group Ⅲ was lower than that of group Ⅰ and group Ⅱ (P <0.05), and diastolic pressure of 24h was lower than that of group Ⅰ (P0.01) and group Ⅱ (P0.05). The incidence of dizziness, headache, redness and ankle edema in group Ⅲ were less than those in group Ⅰ (P <0.05), and those in group Ⅱ were less than those in group Ⅱ (P <0.01). The liver function, renal function, electrolytes, blood lipids, fasting blood glucose, serum uric acid and blood in group Ⅲ were not significantly different from those in group Ⅰ and group Ⅱ before and after treatment. Conclusions: The efficacy of low-dose quadruplex compound in clinical application is better than that of conventional dosage and compound prescription, with less adverse reactions.