补肾活血汤对老年肾虚血瘀型高血压患者血压变异性和生活质量的影响

滕英华; 谢睿; 史先知

doi:10.13422/j.cnki.syfjx.2016200173

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补肾活血汤对老年肾虚血瘀型高血压患者血压变异性和生活质量的影响

临床 | 更新时间：2024-01-04

- 补肾活血汤对老年肾虚血瘀型高血压患者血压变异性和生活质量的影响
- Effect of Bushen Huoxue Decoction to Blood Pressure Variability and Quality of Life of Patients with Kidney Deficiency and Blood Stasis-type Hypertension
- 中国实验方剂学杂志 2016年22卷第20期页码：173-177
- 作者机构：
- 作者简介：
- 基金信息：
  
  黔西南州科学技术局科技计划项目（2013-49）
- DOI：10.13422/j.cnki.syfjx.2016200173
  中图分类号： R259
- 纸质出版日期：2016
- 稿件说明：
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滕英华, 谢睿, 史先知. 补肾活血汤对老年肾虚血瘀型高血压患者血压变异性和生活质量的影响[J]. 中国实验方剂学杂志, 2016,22(20):173-177.

TENG Ying-hua, XIE Rui, SHI Xian-zhi. Effect of Bushen Huoxue Decoction to Blood Pressure Variability and Quality of Life of Patients with Kidney Deficiency and Blood Stasis-type Hypertension[J]. Chinese journal of experimental traditional medical formulae, 2016, 22(20): 173-177.
滕英华, 谢睿, 史先知. 补肾活血汤对老年肾虚血瘀型高血压患者血压变异性和生活质量的影响[J]. 中国实验方剂学杂志, 2016,22(20):173-177. DOI： 10.13422/j.cnki.syfjx.2016200173.

TENG Ying-hua, XIE Rui, SHI Xian-zhi. Effect of Bushen Huoxue Decoction to Blood Pressure Variability and Quality of Life of Patients with Kidney Deficiency and Blood Stasis-type Hypertension[J]. Chinese journal of experimental traditional medical formulae, 2016, 22(20): 173-177. DOI： 10.13422/j.cnki.syfjx.2016200173.

摘要

目的：探讨补肾活血汤治疗肾虚血瘀型老年高血压患者血压变异性（BPV）及对血液流变性、炎症反应、血管内皮功能的影响。方法：将180例患者随机按数字表法分为观察组和对照组各90例。对照组口服硝苯地平控释片，10 mg/次，1次/d；并口服卡托普利，12.5 mg/次，2次/d。观察组在对照组治疗的基础上给予补肾活血汤内服，1剂/d。两组疗程均为12周。采用24 h动态血压监测24 h收缩压标准差（24 hSSD），24 h舒张压标准差（24 hDSD），白天收缩压标准差（dSSD），白天舒张压标准差（dDSD），夜间收缩压标准差（nSSD）和夜间舒张压标准差（nDSD）等BPV指标，并记录24 h平均收缩压（24 hSBP），24 h平均舒张压（24 hDBP），白天平均收缩压（dSBP），白天平均舒张压（dDBP），夜间平均收缩压（nSBP），夜间平均舒张压（nDBP）；生活质量采用健康调查简表（SF-36），进行肾虚血瘀证评分，检测血液流变学指标、一氧化氮（NO），内皮素1（ET-1），白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）。以上指标治疗前后各评价1次。结果：观察组血压疗效总有效率为92.94%，对照组为81.18%，观察组高于对照组（P<0.05）；观察组中医证候疗效总有效率为89.41%，对照组为74.12%，观察组高于对照组（P<0.01）；治疗后观察组24 hSSD，24 hDSD，dSSD，dDSD，nSSD和nDSD均低于对照组（P<0.01）；治疗后观察组24 hSBP，24 hDBP，dSBP，dDBP，nSBP和nDBP均低于对照组（P<0.01）；治疗后观察组SF-36量表各维度评分均高于对照组（P<0.01）；治疗后观察组血液流变学指标均低于对照组（P<0.01）；治疗后观察组IL-6，TNF-α和ET-1水平均低于对照组，NO水平高于对照组（P<0.01）。结论：在西医常规治疗的基础上，加用补肾活血汤治疗老年肾虚血瘀型高血压患者能进一步的降低患者血压，缩小BPV，血压疗效和中医证候疗效均显著，并能提高患者的生活质量，还能改善血液流变学指标，减轻炎症反应，改善内皮功能障碍，从而有利于降低患者靶器官损害的风险。

Abstract

Objective: To discuss effect of Bushen Huoxue decoction on blood pressure variability and old patients with hypertension (kidney deficiency and blood stasis type)

hemorheology

inflammatory response and function of vascular endothelium. Method: Totally 180 patients were divided into control group (90 cases) and combination group (90 cases) by random number table. The patients in control group took nifedipine controlled release tablets

10 mg/time

1 time/day

and captopril

12.5 mg/time

2 times/day. In addition to the therapy for control group

the patients in combination group were given Bushen Huoxue decoction

1 dose/day. The course of treatment lasted for 12 weeks. Before and after the treatment

BPV indexes

such as standard deviation of 24-hour systolic blood pressure (24 h SSD)

standard deviation of 24-hour diastolic blood pressure (24 h DSD)

standard deviation of daytime systolic blood pressure (dSSD)

standard deviation of daytime diastolic blood pressure (dDSD)

standard deviation of night systolic blood pressure (nSSD) and standard deviation of night diastolic blood pressure (nDSD)

were detected by dynamic blood pressure monitoring. And mean 24-hour systolic blood pressure (24 h SBP)

mean 24-hour diastolic blood pressure (24 h DBP)

mean daytime systolic blood pressure (dSBP)

mean daytime diastolic blood pressure (dDSD)

mean night systolic blood pressure (nSBP) and mean night diastolic blood pressure (nDSD) were also recorded. The quality of life was recorded by the short form 36 health survey scale (SF-36) and the kidney deficiency and blood stasis symptom were scored. Levels of nitric oxide (NO)

endothelin 1 (ET-1)

interleukin-6 (IL-6) and tumor necrosises factor-α (TNF-α) were detected. The above indexes were assessed once respectively before and after the treatment. Result: The total rate of effect of blood pressure in combination group was 92.94%

which was higher than 81.18%in control group (P<0.05). The total rate of effect of TCM symptoms in combination group was 89.41%

which was higher than 74.12%in control group (P<0.01). After the treatment

24 h SSD

24 h DSD

dSSD

dDSD

nSSD

nDSD

24 h SBP

24 h DBP

dSBP

dDBP

nSBP and nDBP in combination group were lower than those in control group (P<0.01). Indexes in SF-36 scale were higher than those in control group (P<0.01). Hemorheological indexes and levels of IL-6

TNF-α and ET-1 were lower than those in control group (P<0.01).And level of NO was higher than that in control group (P<0.01). Conclusion: Based on the routine western medicine therapy

Bushen Huoxue decoction can reduce blood pressure and BPV

improve quality of life

ameliorate hemorheological indexes and endothelium dysfunction

and relieve inflammatory response and risk of target-organ damage of old patients with hypertension.

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