目的 探討?zhàn)B血清腦顆粒聯(lián)合纈沙坦氫氯噻嗪片治療老年原發(fā)性高血壓的臨床療效。方法 選取2020年6月—2021年11月在保定市第一醫(yī)院收治的82例老年原發(fā)性高血壓患者為觀察對(duì)象，根據(jù)隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組，每組各41例。對(duì)照組口服纈沙坦氫氯噻嗪片，1片/次，1次/d；治療組在對(duì)照組治療的基礎(chǔ)上溫水沖服養(yǎng)血清腦顆粒，1袋/次，3次/d。兩組患者連續(xù)治療3個(gè)月。觀察兩組的臨床療效，比較兩組的血壓指標(biāo)、血流動(dòng)力學(xué)指標(biāo)、血清指標(biāo)。結(jié)果 治療后，治療組患者的總有效率為95.12%，對(duì)照組的總有效率為80.49%，組間比較差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療后，兩組的24 h收縮壓（24 h SBP）、24 h舒張壓（24 h DBP）、24 h收縮壓標(biāo)準(zhǔn)差（24 h SSD）、24 h舒張壓標(biāo)準(zhǔn)差（24 h DSD）明顯低于治療前（P＜0.05），且治療組24 h SBP、24 h DBP、24 h SSD、24 h DSD低于對(duì)照組（P＜0.05）。治療后，兩組的體循環(huán)阻力（SVR）低于治療前，心排血量（CO）、心臟指數(shù)（CI）高于治療前（P＜0.05）；并且治療組的SVR低于對(duì)照組，CO、CI高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療后，兩組的血清同型半胱氨酸（Hcy）、內(nèi)皮素-1（ET-1）水平低于治療前，一氧化氮（NO）水平高于治療前（P＜0.05）；治療組的Hcy、ET-1水平低于對(duì)照組，NO水平高于對(duì)照組（P＜0.05）。結(jié)論 養(yǎng)血清腦顆粒聯(lián)合纈沙坦氫氯噻嗪片治療老年原發(fā)性高血壓的療效確切，能有效控制血壓，改善血流動(dòng)力學(xué)指標(biāo)和血管內(nèi)皮功能，安全性良好。

Objective To investigate the clinical effect of Yangxue Qingnao Granules combined with Valsartan and Hydrochlorothiazide Tablets in treatment of senile essential hypertension. Methods Patients (82 cases) with senile essential hypertension in Baoding NO.1 Hospital from June 2020 to November 2015 were divided into control and treatment groups according to random number table method, and each group had 41 cases. Patients in the control group were po administered with Valsartan and Hydrochlorothiazide Tablets, 1 tablets/time, once daily. Patients in the treatment group were po administered with Yangxue Qingnao Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and blood pressure indexes, hemodynamic indexes, and serum indexes in two groups were compared. Results After treatment, total effective rate of the treatment group was 95.12%, and the total effective rate of the control group was 80.49%, and the difference between two groups was statistically significant (P < 0.05). After treatment, the 24 h SBP, 24 h DBP, 24 h SSD, and 24 h DSD of two groups were significantly lower than those before treatment (P < 0.05), and the 24 h SBP, 24 h DBP, 24 h SSD, and 24 h DSD of the treatment group were lower than those of the control group (P < 0.05). After treatment, the SVR of two groups was lower than that before treatment, but the CO and CI of two groups were higher than that before treatment (P < 0.05). The SVR of the treatment group was lower than that of the control group, but CO and CI of the treatment group were higher than those of the control group (P < 0.05). After treatment, the levels of Hcy and ET-1 in two groups were lower than those before treatment, but the level of NO in two groups was higher than that before treatment (P < 0.05). The levels of Hcy and ET-1 in the treatment group were lower than those in the control group, but the level of NO in the treatment group was higher than those in the control group (P < 0.05). Conclusion Yangxue Qingnao Granules combined with Valsartan and Hydrochlorothiazide Tablets is effective in the treatment of senile essential hypertension, which can effectively control blood pressure, improve hemodynamic indexes and vascular endothelial function, with good safety.

R972

保定市科技計(jì)劃項(xiàng)目(2041ZF065)