目的 探讨氟哌噻吨美利曲辛治疗顽固性高血压伴焦虑抑郁的疗效观察。方法 105例顽固性高血压患者均为武邑县人民医院2012年1月—2014年12月门诊及住院患者,按照随机原则分为对照组和治疗组,其中对照组52例,治疗组53例。两组患者均采用常规治疗。对照组患者采用3种或以上不同作用机制的降压药,其中苯磺酸左旋氨氯地平片,5 mg/次,1次/d;氢氯噻嗪片,25 mg/次,1次/d;马来酸依那普利片,5 mg/次,1次/d。治疗组在对照组基础上加用氟哌噻吨美利曲辛片,10.5 mg/次,2次/d,早、午各1次口服。两组患者均连续治疗8周。观察两组患者治疗后的临床疗效,对血压的控制水平情况进行监测,同时对治疗前后的汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分进行比较。结果 两组患者治疗后对照组总有效率为78.84%,治疗组为94.33%,两组总有效率比较差异具有统计学意义(P< 0.05)。治疗组治疗后各时间段血压控制水平、HAMD、HAMA评分显著优于对照组(P< 0.05)。结论 常规治疗基础上加用氟哌噻吨美利曲辛片后,血压参数明显改善,平均收缩压和舒张压明显降低,缓解长期高血压引起的抑郁焦虑症状,不良反应少,具有一定的临床推广应用价值。

Objective To investigate flupentixol and melitracen in treatment of resistant hypertension with anxiety and depression. Methods Outpatients and inpatients (105 cases) with resistant hypertension in Hospital of Wuyi County from January 2012 to December 2014 were randomly divided into control group (52 cases) and treatment group (53 cases). Patients in two groups were treated with conventional therapy. And patients in control groups were treated with three or more antihypertensive agents with various mechanisms, including Benzene Sulfonic Acid L-amlodipine Tablets, 5 mg/time, twice daily; Hydrochlorothiazide Tablets, 25 mg/time, once daily; Enalapril Maleate Tablets, 5 mg/time, once daily. The patients in the treatment group were po administered with Flupentixol and Melitracen Tablets at breakfast time and lunch time on the basis of control group, 10.5 mg/time, twice daily. Two groups were treated for 8 weeks. After treatment, the efficacy was evaluated, blood pressure control levels were monitored, and Hamilton anxiety scale (HAMA) and Hamilton depression rating scale (HAMD) scores were compared. Results After treatment, the efficacies in the control and treatment groups were 78.84% and 94.33%, respectively, and there was difference between two groups (P < 0.05). After treatment, blood pressure control levels, HAMD score, and HAMA score improvement were significantly better than those of the control group (P < 0.05) Conclusion Flupentixol and Melitracen Tablets added on conventional therapy in treatment of resistant hypertension with anxiety and depression has better improvement on blood pressure, decreases mean systolic blood pressure and diastolic blood pressure, and relieves the symptoms of depression and anxiety caused by long-term hypertension with low incidence of adverse reactions, which has a certain clinical application value.

衡水市科技支撑计划项目(201444Z)