【摘要】：目的:觀察調(diào)補(bǔ)肝腎湯對(duì)H型高血壓(陰虛陽(yáng)亢證)患者降低血清同型半胱氨酸水平、降低血壓、改善中醫(yī)證候等方面的臨床效果和安全性指標(biāo)。方法:選擇60例符和納入標(biāo)準(zhǔn)的H型高血壓病(陰虛陽(yáng)亢證)患者,隨機(jī)分為對(duì)照組與治療組,每組各30例,兩組患者的年齡、性別、疾病嚴(yán)重程度等無(wú)統(tǒng)計(jì)學(xué)差異。對(duì)照組采取常規(guī)西藥治療,即馬來(lái)酸依那普利葉酸片10mg/0.8mg,一日一次。治療組口服馬來(lái)酸依那普利葉酸片10mg/0.8mg,一日一次,同時(shí)口服調(diào)補(bǔ)肝腎湯,一日三次。治療周期為30天,于治療前后觀察患者血清同型半胱氨酸水平、血壓及中醫(yī)證候指標(biāo),觀察結(jié)果運(yùn)用χ2檢驗(yàn),配對(duì)樣本運(yùn)用t檢驗(yàn)進(jìn)行統(tǒng)計(jì)分析。結(jié)果:1.血清同型半胱氨酸濃度比較,兩組在治療前血清同型半胱氨酸濃度無(wú)顯著性差異;治療后對(duì)照組血清同型半胱氨酸濃度為22.19±3.56umol/L,實(shí)驗(yàn)組血清同型半胱氨酸濃度為18.83±2.38 umol/L,實(shí)驗(yàn)組和對(duì)照組間比較P0.01,有極顯著差異,實(shí)驗(yàn)組降低血清同型半胱氨酸的效果顯著優(yōu)于對(duì)照組。2.治療總有效率:對(duì)照組總有效率為56.67%,治療組總有效率為86.67%,兩組組間比較P0.05,有顯著差異,治療組總有效率高于對(duì)照組;兩組治療前血壓對(duì)比P0.05,差異無(wú)統(tǒng)計(jì)學(xué)意義;兩組治療后血壓對(duì)比P0.05,有顯著差異;3.兩組治療前后中醫(yī)證候改善指標(biāo)比較,P0.05,有顯著差異,治療組對(duì)中醫(yī)證候改善優(yōu)于對(duì)照組;4.治療組和對(duì)照組患者在治療前后均未出現(xiàn)不良反應(yīng),安全觀察指標(biāo)比較無(wú)明顯差異。結(jié)論:調(diào)補(bǔ)肝腎湯治療H型高血壓(陰虛陽(yáng)亢證)安全有效,能明顯改善患者中醫(yī)證候,能同時(shí)降低H型高血壓患者血壓和血清同型半胱氨酸水平,具有很高的臨床應(yīng)用價(jià)值和應(yīng)用前景。
[Abstract]:Objective: to observe the clinical effect and safety index of Tiaoguanshen decoction in reducing serum homocysteine level, lowering blood pressure and improving TCM syndromes in patients with H type hypertension (yin deficiency and yang hyperactivity syndrome). Methods: sixty patients with H type hypertension (yin deficiency and yang hyperactivity) were randomly divided into control group and treatment group with 30 cases in each group. There was no significant difference in age, sex and severity of disease between the two groups. The control group was treated with routine western medicine, that is, 10 mg / 0.8 mg folic acid tablets of enalapril maleate, once a day. In the treatment group, 10 mg / 0.8 mg folic acid tablets of enalapril maleate were given orally, once a day, and oral tonifying liver and kidney decoction, three times a day. The treatment period was 30 days. The serum homocysteine level, blood pressure and TCM syndromes were observed before and after treatment. The results were analyzed by 蠂 2 test and t test. The result is 1: 1. There was no significant difference in serum homocysteine concentration between the two groups before treatment. After treatment, the serum homocysteine concentration in the control group was 22.19 鹵3.56 umol/ L, the serum homocysteine concentration in the experimental group was 18.83 鹵2.38 umol / L, the difference between the experimental group and the control group was very significant (P 0.01). The effect of reducing serum homocysteine in the experimental group was significantly higher than that in the control group (.2.). The total effective rate of treatment: the total effective rate of the control group was 56.67 and the total effective rate of the treatment group was 86.67, the difference between the two groups was significant (P0.05), the total effective rate of the treatment group was higher than that of the control group, the blood pressure of the two groups was higher than that of the control group before treatment, the difference was not statistically significant. There was a significant difference in blood pressure between the two groups after treatment (P 0.05). There was significant difference between the two groups before and after treatment. The improvement of TCM syndrome in the treatment group was better than that in the control group (P 0.05). There were no adverse reactions before and after treatment in the treatment group and the control group, and there was no significant difference in the safety observation index between the treatment group and the control group. Conclusion: Tiaoguanshen decoction is safe and effective in treating H type hypertension (Yin deficiency and yang hyperactivity syndrome), it can obviously improve the syndrome of traditional Chinese medicine, decrease blood pressure and serum homocysteine level in patients with H type hypertension at the same time. It has high clinical application value and application prospect.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

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