目的 探討復(fù)方丹參滴丸聯(lián)合苯磺酸左旋氨氯地平片治療老年單純收縮期高血壓患者的臨床療效。方法 選取北京市密云區(qū)果園社區(qū)衛(wèi)生服務(wù)中心2014年8月-2015年8月就診的單純收縮期高血壓患者80例,所有患者按照隨機(jī)數(shù)表法隨機(jī)分為對(duì)照組和治療組,每組各40例。兩組患者給予常規(guī)降壓治療。對(duì)照組口服苯磺酸左旋氨氯地平片,5 mg/次,1次/d;治療組在對(duì)照組基礎(chǔ)上口服復(fù)方丹參滴丸,40丸/次,2次/d。兩組患者均持續(xù)治療3個(gè)月。觀察兩組的臨床療效,比較治療前后兩組患者各項(xiàng)血壓指標(biāo)、血脂指標(biāo)、血壓節(jié)律晝夜變化有效率、肱動(dòng)脈血管內(nèi)徑及擴(kuò)張情況。結(jié)果 治療后,對(duì)照組、治療組總有效率分別為72.50%、92.50%,兩組患者總有效率比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者的24 h舒張壓、24 h收縮壓、白晝血壓負(fù)荷以及夜間血壓負(fù)荷均顯著降低,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,治療組患者TC、LDL-C均顯著降低,同組治療前后差異均具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)降低程度明顯優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,對(duì)照組舒張壓和收縮壓的血壓節(jié)律晝夜變化有效率分別為30.00%、35.00%,治療組的分別為80.00%、87.50%,兩組患者舒張壓和收縮壓的血壓節(jié)律晝夜變化有效率比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者血管擴(kuò)張百分比顯著升高,同組治療前后差異均具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這個(gè)觀察指標(biāo)升高程度明顯優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 復(fù)方丹參滴丸聯(lián)合苯磺酸左旋氨氯地平片治療老年單純收縮期高血壓具有較好臨床癥狀,能夠提高血壓節(jié)律晝夜變化有效率,無明顯不良反應(yīng),具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To discuss the clinical effect of Compound Danshen Dripping Pills combined with Levamlodiping Besylate Tablets in treatment of elderly isolated systolic hypertension.Methods Patients (80 cases) with isolated systolic hypertension in Beijing Miyun District Guoyuan Community Health Service Center from August 2014 to August 2015 were divided into control and treatment groups according to the random number table, and each group had 40 cases. All patients in two groups were given the conventional treatment. The patients in the control group were po administered with Levamlodiping Besylate Tablets, 5 mg/time, once daily. The patients in the treatment group were poadministered with Compound Danshen Dripping Pills on the basis of control group, 40 pills/time, twice daily. The patients in two groups were treated for 3 months. After treatment, the efficacies were evaluated, and the blood pressure indicators, blood lipid changes, the circadian rhythm of blood pressure changes, inner diameter of blood and expansion in two groups were compared.Results After treatment, the efficacies in the control and treatment groups were 72.50% and 92.50%, respectively, and there were differences between two groups (P<0.05). After treatment, 24 h diastolic blood pressure, 24 h systolic blood pressure, daytime blood pressure load, and the value of nighttime blood pressure load in two groups were significantly decreased, with significant difference between two groups (P < 0.05). After treatment, the levels of TC and LDL-C in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly decreased than those in the control group, with significant difference between two groups (P < 0.05). Circadian rhythms of diastolic and systolic blood pressure changes in the control and treatment groups were 30.00%, 35.00% and 80.00%, 87.50%, respectively, and there were differences between two groups (P<0.05). After treatment, blood expansions in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). After treatment, blood expansions in two groups were significantly decreased, with significant difference between two groups (P < 0.05).Conclusion Compound Danshen Dripping Pills combined with Levamlodiping Besylate Tablets has clinical curative effect in the treatment of elderly isolated systolic hypertension, can raise blood pressure circadian rhythm changes efficiently, is less adverse reactions, which has a certain clinical application value.