温胆泄浊法对痰浊型高血压病患者血管内皮舒张功能与粥样硬化改善作用的超声研究

Ultrasonographic Study on Effects of Wendan Xiezhuo Method in Improving Vascular Endothelial Diastolic Function and Atherosclerosis in Hypertension Patients with Turbid-Phlegm Syndrome

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中文关键词: 高血压痛温胆泄浊法血管内皮舒张功能超声

英文关键词:essential hypertension Wendan Xiezhuo method vascular endothelial function ultrasono-graphy

基金项目:广东省科学技术厅资助课题(No.53009)

作者	单位
赵萍	广州中医药大学附属第一医院超声科
陈洁	广州中医药大学附属第一医院超声科
洪永敦	广州中医药大学附属第一医院心内科
曾燕静	广州中医药大学附属第一医院超声科

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中文摘要:

目的评价温胆泄浊法对痰浊型原发性高血压病患者颈动脉粥样硬化和血管内皮舒张功能异常的调节作用。方法随机选择低危、中危性的痰浊型原发性高血压病患者43例,其中温胆片组23例,安慰剂组20例。在氨氯地平有效控制血压基础上分别加用温胆片或安慰剂。彩超检测治疗前和治疗6个月后患者颈动脉内膜-中膜厚度(IMT)、斑块积分、斑块面积,肱动脉充血后和含服硝酸甘油后肱动脉内径的变化。结果温胆片组患者治疗后痰浊积分较安慰剂组有显著性改善、IMT减少、颈动脉斑块积分降低(均P <0．05);颈动脉斑块面积显著性减少(P<0．01);高血压病患者肱动脉内皮依赖性舒张功能与颈动脉IMT间呈负相关(r=-0．596,P<0．05);治疗后内皮依赖性舒张功能改善,且温胆片组优于安慰剂组,但非内皮依赖性舒张功能两组比较差异无显著性。结论痰浊型高血压病患者肱动脉内皮依赖性舒张功能与颈动脉IMT呈负相关。温胆泄浊法对颈动脉斑块和肱动脉内皮依赖性舒张功能异常有较好的改善作用。

英文摘要:

Objective To observe the effect of Wendan Xiezhuo method (WXM) on carotid arteriosclerosis and vascular endothelial diastolic function in essential hypertension (EH) patients with turbid-phlegm syndrome (TPS). Methods Forty-three EH patients of medium and low risk with TPS were randomly assigned to two groups, the Wendan Tablet (WT) group (23 cases) and the placebo group (20 cases), they were treated with WT and placebo respectively on the base of amlodipine treatment to control the blood pressure. Carotid intima-media thickness (IMT), atherosclerotic plaque score of carotid artery, endothelium-dependent dilation (EDD) and flow-mediated vasodilation (FMD) of brachial artery after taking nitroglycerin were detected with ultrasono-graphy before and after 6 months of treatment. Results As compared with those in the placebo group, in the WT group after treatment, scores of TPS and carotid plaque were better, area of carotid plaque was lesser and IMT was lower significantly (P<0.05 or P<0.01). There was a negative correlation between brachial artery EDD and carotid IMT in EH patients with TPS (r=-0.596, P<0.05). After treatment EDD was improved more significantly in the WT group than that in the placebo group, however, no significant difference was found in non-cndothelium-dependent dilation between the two groups. Conclusion A negative correlation exists between brachial artery EDD and carotid IMT, and the latter could be aggravated by TPS in EH patients. WXM shows favorable effects in improving carotid plaque and EDD.

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