本文選題：高血壓病　切入點(diǎn)：肝陽(yáng)上亢　出處：《山西醫(yī)科大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:觀察口服平肝抑眩膏聯(lián)合苯磺酸左旋氨氯地平片治療肝陽(yáng)上亢型輕中度高血壓病的臨床療效,觀察其對(duì)高血壓病患者臨床癥狀、動(dòng)態(tài)血壓的影響,進(jìn)一步探求中西醫(yī)結(jié)合治療該病的臨床有效性、穩(wěn)定性及安全性,為中西醫(yī)結(jié)合防治該病提供相關(guān)臨床依據(jù)。方法:本研究按照隨機(jī)對(duì)照的原則,納入肝陽(yáng)上亢型輕中度高血壓病患者60例,分為治療組和對(duì)照組各30例。對(duì)照組給予口服苯磺酸左旋氨氯地平片(施慧達(dá)藥業(yè)集團(tuán)有限公司生產(chǎn),批準(zhǔn)文號(hào):國(guó)藥準(zhǔn)字H19991083),用法為2.5mg每次,每日早晨7點(diǎn)空腹口服。治療組在給予上述口服藥物基礎(chǔ)上加服平肝抑眩膏,本膏方為山西醫(yī)科大學(xué)第二醫(yī)院董聯(lián)玲教授經(jīng)驗(yàn)方,由女貞子玉竹100g,竹茹100g,麥冬150g,黃精150g,枸杞子150g,何首烏120g,山萸肉120g,桑椹120g,鉤藤150g,白芍100g,丹參120g,遠(yuǎn)志100g,石菖蒲100g,柏子仁100g,西洋參100g,龜甲膠200g等組成。膏方的制作參照膏劑的傳統(tǒng)加工工藝流程,由山西省中醫(yī)藥研究所制劑室制訂,按照標(biāo)準(zhǔn)化、規(guī)范化操作,從而確保膏滋的質(zhì)量和療效。用法:餐后口服,20g/次,早晚分服,4周一療程,兩組同時(shí)治療兩個(gè)療程。詳細(xì)記錄治療前后兩組患者安全性指標(biāo)、證候指標(biāo)及24小時(shí)動(dòng)態(tài)血壓數(shù)據(jù)[動(dòng)態(tài)血壓由用美國(guó)SP(a)celabs Medical公司生產(chǎn)的9027.ABP型動(dòng)態(tài)血壓記錄儀(ABPM)監(jiān)測(cè)],并對(duì)實(shí)驗(yàn)數(shù)據(jù)進(jìn)行整理及統(tǒng)計(jì)分析。結(jié)果:1.療效性評(píng)價(jià):(1)從證候積分角度分析聯(lián)合治療組總有效率為96%,單純西藥組總有效率為83%。聯(lián)合用藥組癥候改善效果明顯優(yōu)于對(duì)照組。(2)聯(lián)合用藥組總有效率為96%,高于單純西藥組,聯(lián)合治療降壓幅度優(yōu)于單純西藥組。(3)兩組經(jīng)治療,動(dòng)態(tài)血壓變異性(Ambulatory blood pressure variability,ABPV,通常由血壓變異系數(shù)CV來(lái)表示)及晝夜節(jié)律均改善,治療組轉(zhuǎn)為杓型血壓百分比為41%,明顯優(yōu)于對(duì)照組的轉(zhuǎn)為杓型百分比17%。2.安全性評(píng)價(jià):兩組患者治療前后安全性指標(biāo)經(jīng)統(tǒng)計(jì)分析差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),藥物均安全。結(jié)論:1.平肝抑眩膏聯(lián)合苯磺酸左旋氨氯地平片組治療肝陽(yáng)上亢型輕中度高血壓病對(duì)比單純口服苯磺酸左旋氨氯地平片組,降壓效果更加顯著、平穩(wěn),對(duì)于血壓晝夜節(jié)律及血壓變異性的改善程度更大,能更大程度降低心腦血管疾病發(fā)生風(fēng)險(xiǎn)。2.試驗(yàn)過(guò)程中未發(fā)現(xiàn)肝腎功能損傷等安全性問(wèn)題,治療藥物安全可靠。
[Abstract]:Objective: to observe the clinical effect of oral Pinggan Yixuan ointment combined with levamlodipine benzenesulfonic acid tablets in the treatment of mild and moderate hypertension with hyperactivity of liver-yang, and to observe its effect on clinical symptoms and ambulatory blood pressure of patients with hypertension. To further explore the clinical efficacy, stability and safety of integrated traditional Chinese and western medicine in the treatment of the disease, to provide the relevant clinical basis for the prevention and treatment of the disease. Methods: according to the principle of random control, Sixty patients with liver-yang hyperactivity type mild and moderate hypertension were divided into treatment group (n = 30) and control group (n = 30). The control group was treated with oral L-amlodipine benzenesulfonic acid tablets (produced by Shwe Huida Pharmaceutical Group Co., Ltd.). Approval symbol: Chinese medicine standard H19991083, used 2.5mg every time, every morning at 7 o'clock empty stomach. Treatment group on the basis of the above oral drugs plus Pinggan Yixuan ointment, this paste prescription is Professor Dong Lianling of Shanxi Medical University, It is composed of Ligustrum lucidum 100g, bamboo Ru 100g, wheat winter 150g, yellow essence 150g, medlar 150g, Polygonum multiflorum 120g, cornwood 120g, mulberry 120g, hookwood 150g, white peony 100g, salvia miltiorrhiza 120g, Yuanqi 100g, calamus 100g, cypress seed 100g, Panax quinquefolium 100g, tortoise gum 200g etc. The traditional processing process of paste, Formulated by the preparation room of Shanxi Institute of traditional Chinese Medicine, standardized and standardized operation to ensure the quality and curative effect of plaster. Usage: 20 g / time after meal, 4 weeks a course of treatment in the morning and evening, The safety indexes of the two groups before and after treatment were recorded in detail. Syndrome indexes and 24-hour ambulatory blood pressure data (ABPM) were monitored by 9027.ABP ambulatory blood pressure recorder produced by SP(a)celabs Medical, USA, and the experimental data were collated and statistically analyzed. Results: 1. Evaluation of curative effect: 1. The total effective rate of the combined treatment group was 96. The total effective rate of the western medicine group was 83. The symptom improvement effect of the combined treatment group was significantly better than that of the control group.) the total effective rate of the combined treatment group was 96, which was higher than that of the western medicine group. After treatment, the ambulatory blood pressure variability of ABPVs, usually expressed by the coefficient of variation of blood pressure (CV), and the circadian rhythm were improved. The percentage of dipper blood pressure in the treatment group was 41%, which was significantly better than that in the control group 17. 2. Safety evaluation: there was no significant difference in the safety indexes between the two groups before and after treatment (P 0.05), and the drugs were all safe. Discussion on the effect of Pinggan Yixuan Ointment combined with L-amlodipine Benesulfonic Acid tablets in the treatment of liver Yang hyperactivity mild and moderate Hypertension, compared with the simple oral administration of L-amlodipine benzenesulfonic acid tablet group, The effect of lowering blood pressure is more significant and stable, the improvement of circadian rhythm of blood pressure and blood pressure variability is greater, and the risk of cardiovascular and cerebrovascular diseases can be reduced to a greater extent. 2. No safety problems such as liver and kidney function damage were found in the course of the trial. The medicine is safe and reliable.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R544.1

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