目的 探讨清肝降压胶囊联合非洛地平治疗原发性高血压的临床疗效。方法 选取2023年12月—2024年12月北京市昌平区沙河医院收治的168例原发性高血压患者，随机分为对照组和治疗组，每组各84例。对照组早晨空腹口服非洛地平缓释片，5 mg/次，1次/d。在对照基础上，治疗组饭后30 min口服清肝降压胶囊，3粒/次，3次/d。两组疗程8周。比较两组临床疗效，治疗前后舒张压（DBP）、收缩压（SBP）及24 h平均血压（24 h DBP、24 h SBP），中医高血压患者报告结局量表（PRO）和症状自评量表（SCL-90）评分，以及中性粒细胞与淋巴细胞比值（NLR）和血清脂蛋白相关磷脂酶A₂（Lp-PLA₂）、可溶性血管细胞黏附分子-1（sVCAM-1）、一氧化氮（NO）、内皮素-1（ET-1）、血管紧张素Ⅱ（AngⅡ）水平。结果 治疗后，治疗组总有效率较对照组（96.43% vs 88.10%）显著更高（P＜0.05）。治疗后，两组DBP、SBP及24 h DBP、24 h SBP降低（P＜0.05），且治疗组低于对照组（P＜0.05）。治疗后，两组中医高血压PRO评分增加，SCL-90评分减少（P＜0.05），且治疗组评分优于对照组（P＜0.05）。治疗后，两组患者NLR和血清Lp-PLA₂、sVCAM-1、ET-1、AngⅡ水平下降，而血清NO水平升高（P＜0.05），且治疗组NLR和血清Lp-PLA₂、sVCAM-1、ET-1、AngⅡ水平低于对照组，血清NO水平高于对照组（P＜0.05）。结论 原发性高血压患者采用清肝降压胶囊联合非洛地平治疗，能在减轻机体炎症反应、抑制血管内皮损害及调节神经-体液紊乱方面获得良好效果，利于提升血压控制水平，改善生活质量，减轻心理负担。

Objective To explore the clinical efficacy of Qinggan Jiangya Capsules combined with felodipine in treatment of essential hypertension. Methods A total of 168 patients with essential hypertension admitted to Shahe Hospital of Changping District, Beijing from December 2023 to December 2024 were enrolled and randomly divided into a control group and a treatment group, with 84 cases in each group. The control group received oral felodipine sustained-release tablets at a dose of 5 mg once daily on an empty stomach in the morning. On the basis of the control treatment, the treatment group was additionally given oral Qinggan Jiangya Capsules 30 minutes after meals, 3 capsules each time, three times a day. The treatment course lasted for 8 weeks in both groups. Clinical efficacy, diastolic blood pressure (DBP), systolic blood pressure (SBP), 24-hour mean diastolic blood pressure (24 h DBP) and 24-hour mean systolic blood pressure (24 h SBP) were compared before and after treatment. The Patient-Reported Outcome (PRO) scale for hypertensive patients of traditional Chinese medicine and Symptom Checklist-90 (SCL-90) scores were evaluated. In addition, the neutrophil-to-lymphocyte ratio (NLR) and serum levels of lipoprotein-associated phospholipase A₂ (Lp-PLA₂), soluble vascular cell adhesion molecule-1 (sVCAM-1), nitric oxide (NO), endothelin-1 (ET-1) and angiotensin Ⅱ (AngⅡ) were detected and compared. Results After treatment, the total effective rate of the treatment group was significantly higher than that of the control group (96.43% vs 88.10%, P < 0.05). DBP, SBP, 24 h DBP and 24 h SBP were decreased in both groups after treatment (P < 0.05), and these indicators were lower in the treatment group (P < 0.05). The TCM hypertension PRO scores increased while SCL-90 scores decreased in both groups (P < 0.05), with better outcomes observed in the treatment group (P < 0.05). After treatment, the levels of NLR and serum Lp-PLA2, sVCAM-1, ET-1, and AngⅡ in both groups decreased, but serum NO level increased (P < 0.05). Moreover, the levels of NLR and serum Lp-PLA2, sVCAM-1, ET-1, and AngⅡ in treatment group were lower than those in control group, and the serum NO level was higher than that in control group (P < 0.05). Conclusion For patients with essential hypertension, the combined therapy of Qinggan Jiangya Capsules and felodipine can effectively alleviate systemic inflammatory responses, inhibit vascular endothelial damage and regulate neurohumoral disorders. It improves blood pressure control, relieves psychological stress and enhances quality of life.

R972

世界中联中医疗养研究专业委员会中医疗养学科研项目（2023zyly020）