目的 探讨养血清脑颗粒联合缬沙坦氢氯噻嗪片治疗老年原发性高血压的临床疗效。方法 选取2020年6月—2021年11月在保定市第一医院收治的82例老年原发性高血压患者为观察对象，根据随机数字表法将所有患者分为对照组和治疗组，每组各41例。对照组口服缬沙坦氢氯噻嗪片，1片/次，1次/d；治疗组在对照组治疗的基础上温水冲服养血清脑颗粒，1袋/次，3次/d。两组患者连续治疗3个月。观察两组的临床疗效，比较两组的血压指标、血流动力学指标、血清指标。结果 治疗后，治疗组患者的总有效率为95.12%，对照组的总有效率为80.49%，组间比较差异有统计学意义（P＜0.05）。治疗后，两组的24 h收缩压（24 h SBP）、24 h舒张压（24 h DBP）、24 h收缩压标准差（24 h SSD）、24 h舒张压标准差（24 h DSD）明显低于治疗前（P＜0.05），且治疗组24 h SBP、24 h DBP、24 h SSD、24 h DSD低于对照组（P＜0.05）。治疗后，两组的体循环阻力（SVR）低于治疗前，心排血量（CO）、心脏指数（CI）高于治疗前（P＜0.05）；并且治疗组的SVR低于对照组，CO、CI高于对照组，差异有统计学意义（P＜0.05）。治疗后，两组的血清同型半胱氨酸（Hcy）、内皮素-1（ET-1）水平低于治疗前，一氧化氮（NO）水平高于治疗前（P＜0.05）；治疗组的Hcy、ET-1水平低于对照组，NO水平高于对照组（P＜0.05）。结论 养血清脑颗粒联合缬沙坦氢氯噻嗪片治疗老年原发性高血压的疗效确切，能有效控制血压，改善血流动力学指标和血管内皮功能，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

保定市科技计划项目(2041ZF065)