清眩调压方治疗更年期女性高血压病的临床研究

目的探讨清眩调压方对更年期女性高血压病的降压效果及作用机理。方法将87例患者随机分为对照组(43例)和试验组(44例),对照组给予培哚普利片加中药模拟剂,试验组给予培哚普利片加清眩调压方颗粒剂,疗程2个月,治疗前后分别检测患者动态血压(ABMP)、心率、相关临床症状、血脂、血清雌二醇(E2)、超敏C反应蛋白(Hs-CRP)、同型半胱氨酸(HCY)、血管紧张素Ⅱ(AngⅡ)的水平。结果治疗后,试验组可显著降低血压变异性和夜间血压下降率,且优于对照组(P<0.05),降压的总有效率和显效率也优于对照组(P<0.05);试验组对头痛、腰酸、膝软、失眠症状改善明显(P<0.05);在降低心率、总胆固醇(TC)、低密度脂蛋白(LDL-C)方面明显优于对照组(P<0.05);内源性血浆E2水平较治疗前上升(P<0.05),而对照组治疗前后变化无统计学意义;试验组降低血浆Hs-CRP、AngⅡ水平,升高内源性血浆E2水平优于对照组(P<0.05)。结论清眩调压方对更年期女性高血压患者具有较好的降压作用,能降低更年期女性高血压的血压变异性,改善患者更年期综合征症状、血脂代谢及血浆E2、Hs-CRP、AngⅡ水平,提示其作用机理可能与调节交感-迷走神经功能、神经-内分泌-免疫功能及抑制循环肾素-血管紧张素-醛固酮系统(RAAS)活性有关。

英文摘要:

Objective To investigate the effect and mechanism of Qingxuan Tiaoya Recipe (QXTYR) on depressing blood pressure in menopausal women with hypertension. Methods Patients were randomly assigned to two groups,the 44 patients in the test group were administered with perindopril tablet and QXTYR granule,while the 43 in the control group were administered with the same program,but a simulator of QXTYR was used to replace for the real one. The treatment course for them all was 2 months. Before and after treatment,the ambulatory blood pressure (ABMP),heart rate,related clinical symptoms,blood lipids,serum estrodiol (E2),high-sensitivity C-reactive protein (Hs-CRP),homocysteine (HCY) and angiotensinⅡ (AngⅡ) were measured. Results The treatment in the test group showed an effect better than that in the control group in terms of reducing blood pressure variability and night-time blood pressure decrease rate (P<0.05),with the total effective rate and markedly effective rate in lowering blood pressure superior to the control group (P<0.05),alleviating symptoms as headache,soreness and weakness of the waist and knees,and insomnia (P<0.05),and decreasing levels of heart rate,total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),Hs-CRP and AngⅡ (P<0.05),The plasma level of endogenous E2 was elevated after treatment in the test group (P<0.05),but showed no statistical difference in the control group. Conclusions QXTYR shows favorable effect in depressing blood pressure of menopausal women with hypertension,it can reduce blood pressure variability,improve the symptoms of the menopause syndrome,blood lipid metabolism and plasma levels of Hs-CRP,E2,and AngⅡ in patients,suggesting that its mechanism may be related to the functional regulation of sympathetic-vagus nerve and neuro-endocroimmune system,and also the inhibition on the circulatory renin-angiotensin-aldosterone system activity.

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