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[摘要]
目的 探讨心脉通胶囊联合左旋氨氯地平治疗老年高血压的临床效果。方法 选取2015年9月—2018年9月亳州市人民医院收治的老年高血压患者66例,随机分成对照组(33例)和治疗组(33例)。对照组口服苯磺酸左旋氨氯地平片,初始剂量2.5 mg/次,1次/d,服药2周后剂量调整至5 mg/次,1次/d。治疗组在对照组的基础上口服心脉通胶囊,3粒/次,3次/d。两组均连续治疗12周。观察两组患者临床疗效,同时比较治疗前后两组患者动态血压相关参数、血脂水平、血流变学参数及血小板最大聚集率(PAGM)和肱踝动脉脉搏波传导速度(baPWV)值。结果 治疗后,对照组临床有效率为75.8%,显著低于治疗组的93.9%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组动态血压相关参数24 h平均收缩压(SBP)、24 h平均舒张压(DBP)、白天平均收缩压(D-SBP)、白天平均舒张压(D-DBP)、夜间平均收缩压(N-SBP)和夜间平均舒张压(N-DBP)以及脉压和血压昼夜节律异常率均显著下降(P<0.05),且治疗组患者动态血压相关参数明显低于对照组P<0.05)。治疗后,治疗组血清总胆固醇(TC)、三酰甘油(TG)水平均显著降低(P<0.05),且治疗组患者TC、TG水平明显低于对照组(P<0.05)。治疗后,两组全血黏度高切(WHV)、全血黏度低切(WLV)和红细胞聚集指数(RCAI)值均显著减小(P<0.05),变形指数(RDI)值则均显著增大(P<0.05),且治疗组患者血流变学参数明显好于对照组(P<0.05)。治疗后,两组患者PAGM和baPWV值均显著下降(P<0.05),且治疗组患者PAGM和baPWV值明显低于对照组(P<0.05)。结论 心脉通胶囊联合左旋氨氯地平治疗老年高血压的疗效确切,可平稳地控制患者血压,降低血脂水平,改善血流变学,改善血管功能。
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[Abstract]
Objective To investigate the clinical effect of Xinmaitong Capsules combined with levamlodipine in treatment of senile hypertension. Methods Patients (66 cases) with hypertension in Bozhou People's Hospital from September 2015 to September 2018 were randomly divided into control (33 cases) and treatment (33 cases) groups. Patients in the control group were po administered with Levamlodipine Besylate Tablets, the initial dose was 2.5 mg/time, once weekly, and the dose was adjusted to 5 mg/time after 2 weeks. Patients in the treatment group were po administered with Xinmaitong Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the related parameters of dynamic blood pressure, blood lipid levels, blood flow parameters, PAGM and baPWV values in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 75.8%, which was significantly lower than 93.9% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the 24 h-SBP, 24 h-DBP, D-SBP, D-DBP, N-SBP, N-DBP, pulse pressure, and abnormal circadian rhythm of blood pressure in two groups were significantly decreased (P<0.05), and these parameters in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the serum TC and TG levels in two groups was significantly decreased (P<0.05), and which in the treatment group was significantly lower than that in the control group (P<0.05). After treatment, the WHV, WLV, and RCAI values in two groups were significantly decreased (P<0.05), RDI values in two groups were significantly increased (P<0.05), and these blood flow parameters in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the PAGM and baPWV values in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Xinmaitong Capsules combined with levamlodipine in treatment of senile hypertension is effective and can obviously control blood pressure, reduce blood lipid level, improve blood rheology and vascular function.
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