目的 探讨天麻钩藤饮联合奥美沙坦治疗肝阳上亢型原发性高血压的临床效果。方法 选取2016年6月-2019年6月在上海市光华中西医结合医院就诊的肝阳上亢型原发性高血压患者150例，随机分为对照组和治疗组，每组各75例。对照组口服奥美沙坦酯片，20~40 mg/次，1次/d。治疗组在对照组的基础上口服天麻钩藤饮，每天1剂，分早晚两次服用。两组患者治疗8周。观察两组患者临床疗效，同时比较治疗前后两组患者血压变化和中医证候积分。结果 治疗后，治疗组总有效率是94.67%，显著高于对照组84.00%（P<0.05）。治疗后，两组患者收缩压和舒张压明显下降（P<0.05），且治疗组比对照组下降更明显（P<0.05）。治疗后，两组患者中医证候积分均明显下降（P<0.05），且治疗组比对照组下降更明显（P<0.05）。结论 天麻钩藤饮联合奥美沙坦治疗肝阳上亢型原发性高血压患者更具优势，且安全性高。

Objective To explore the clinical effects of Tianma Gouteng Decoction combined with olmesartan in treatment of essential hypertension of liver-yang syndrome. Methods Patients (150 cases) with essential hypertension of liver-yang syndrome in Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine from June 2016 to June 2019 were randomly divided into control and treatment groups, and each group had 75 cases. Patients in the control group were po administered with Olmesartan Medoxomil Tablets, 20-40 mg/time, once daily. Patients in the treatment group were po administered with Tianma Gouteng Decoction on the basis of the control group, morning and evening twice a dose of drug. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated, and the blood pressure and TCM symptom scores in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 94.67%, significantly higher than that of the control group (84.00%, P<0.05). After treatment, the systolic and diastolic blood pressure in two groups were significantly decreased (P<0.05), and the blood pressure in the treatment group was significantly lower than that in the control group (P<0.05). After treatment, the TCM symptom scores in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than that in the control group (P<0.05). Conclusion Tianma Gouteng Decoction combined with olmesartan in treatment of essential hypertension of liver-yang syndrome has more advantages, and high safety.

R972

上海市长宁区青年中医医师培养计划项目（2015CNQNZY003）