高血压/药物疗法%肥大,左心室/病因学%高血压/并发症%心室功能,左/药物作用%神经肽Y/血液
高血壓/藥物療法%肥大,左心室/病因學%高血壓/併髮癥%心室功能,左/藥物作用%神經肽Y/血液
고혈압/약물요법%비대,좌심실/병인학%고혈압/병발증%심실공능,좌/약물작용%신경태Y/혈액
背景:原发性高血压引起的左室肥厚是发生各种心血管并发症具有独立作用的危险因子,逆转左室肥厚已成为当前高血压治疗的重要目标之一.血浆神经肽Y有内皮源性缩血管作用,通过对血管内皮细胞的作用发挥对血管舒缩功能的调节作用而参与高血压的发病和维持.目的:观察益心降压胶囊对阴虚阳亢血瘀证型2级原发性高血压左室肥厚患者左室质量指数及神经肽Y含量的影响.设计:以患者为观察对象,病例分析.单位:解放军济南军区总医院中医科;山东中医药大学附属医院内科.对象:选择2003-03/2005-08解放军济南军区总医院、山东中医药大学附属医院93例自愿参加本实验的阴虚阳亢血瘀证型2级原发性高血压左室肥厚患者.采用随机数字表将患者分为两组.观察组62例,男40例,女22例;年龄46～70岁,平均58.94岁;病程2～19年,平均8.93年.对照组31例,男19例,女12例;年龄44～69岁,平均59.27岁;病程2.5～18年,平均9.11年.另设健康组30例,均来自健康体检人群.方法:两组患者均口服依那普利片,每次10 mg,每日1次.观察组加服益心降压胶囊(药物组成为:生地黄、生首乌、桑寄生、川牛膝、钩藤、石决明、夏枯草、天麻、牡丹皮、赤芍药、地龙、穿山龙等,按比例配方,提取浓缩,装入胶囊,每粒0.5 g,每克含生药4.65 g,由山东济南宏济堂制药有限责任公司提供,批号:021214),每次5粒,每日3次.两组疗程均为24周.采用超声心动图仪和放射免疫分析法分别测定两组患者治疗前后左室质量指数和血浆神经肽Y含量.同时测定健康组上述指标作对照.主要观察指标:左室质量指数和血浆神经肽Y含量变化;血压变化;不良事件及副反应.结果:93例患者均进入结果分析.①治疗前观察组和对照组患者左室质量指数和血浆神经肽Y含量均较健康组显著升高[(147.2±16.9),(146.7±17.2),(101.8±22.4)g/m2;(135.4±33.2),(133.8±31.1),(78.6±24.5)ng/L;P＜0.01];②治疗24周后两组患者左室质量指数和血浆神经肽Y含量均显著降低,且观察组优于对照组[(103.9±24.6),(122.6±19.9)g/m2;(82.9±25.2),(113.7±26.2)ng/L;P＜0.05～0.01].③观察组治疗后左室质量指数和血浆神经肽Y含量与健康组比较差异无显著性(P＞0.05),对照组仍高于健康组(P＜0.01).④观察组和对照组收缩压、舒张压下降幅度比较差异无显著性[(137.4±12.8),(134.2±11.9)mm Hg;(80.1±8.3),(81.7±7.4)mm Hg,P＞0.05].两组患者治疗前后血常规和肝肾功能均无明显变化,治疗过程均未出现不良反应.结论:阴虚阳亢血瘀证型2级原发性高血压左室肥厚患者左室质量指数和血浆神经肽Y含量显著高于健康人;在依那普利应用基础上服用益心降压胶囊具有较好的逆转左室肥厚和降低血浆神经肽Y含量的作用.
揹景:原髮性高血壓引起的左室肥厚是髮生各種心血管併髮癥具有獨立作用的危險因子,逆轉左室肥厚已成為噹前高血壓治療的重要目標之一.血漿神經肽Y有內皮源性縮血管作用,通過對血管內皮細胞的作用髮揮對血管舒縮功能的調節作用而參與高血壓的髮病和維持.目的:觀察益心降壓膠囊對陰虛暘亢血瘀證型2級原髮性高血壓左室肥厚患者左室質量指數及神經肽Y含量的影響.設計:以患者為觀察對象,病例分析.單位:解放軍濟南軍區總醫院中醫科;山東中醫藥大學附屬醫院內科.對象:選擇2003-03/2005-08解放軍濟南軍區總醫院、山東中醫藥大學附屬醫院93例自願參加本實驗的陰虛暘亢血瘀證型2級原髮性高血壓左室肥厚患者.採用隨機數字錶將患者分為兩組.觀察組62例,男40例,女22例;年齡46～70歲,平均58.94歲;病程2～19年,平均8.93年.對照組31例,男19例,女12例;年齡44～69歲,平均59.27歲;病程2.5～18年,平均9.11年.另設健康組30例,均來自健康體檢人群.方法:兩組患者均口服依那普利片,每次10 mg,每日1次.觀察組加服益心降壓膠囊(藥物組成為:生地黃、生首烏、桑寄生、川牛膝、鉤籐、石決明、夏枯草、天痳、牡丹皮、赤芍藥、地龍、穿山龍等,按比例配方,提取濃縮,裝入膠囊,每粒0.5 g,每剋含生藥4.65 g,由山東濟南宏濟堂製藥有限責任公司提供,批號:021214),每次5粒,每日3次.兩組療程均為24週.採用超聲心動圖儀和放射免疫分析法分彆測定兩組患者治療前後左室質量指數和血漿神經肽Y含量.同時測定健康組上述指標作對照.主要觀察指標:左室質量指數和血漿神經肽Y含量變化;血壓變化;不良事件及副反應.結果:93例患者均進入結果分析.①治療前觀察組和對照組患者左室質量指數和血漿神經肽Y含量均較健康組顯著升高[(147.2±16.9),(146.7±17.2),(101.8±22.4)g/m2;(135.4±33.2),(133.8±31.1),(78.6±24.5)ng/L;P＜0.01];②治療24週後兩組患者左室質量指數和血漿神經肽Y含量均顯著降低,且觀察組優于對照組[(103.9±24.6),(122.6±19.9)g/m2;(82.9±25.2),(113.7±26.2)ng/L;P＜0.05～0.01].③觀察組治療後左室質量指數和血漿神經肽Y含量與健康組比較差異無顯著性(P＞0.05),對照組仍高于健康組(P＜0.01).④觀察組和對照組收縮壓、舒張壓下降幅度比較差異無顯著性[(137.4±12.8),(134.2±11.9)mm Hg;(80.1±8.3),(81.7±7.4)mm Hg,P＞0.05].兩組患者治療前後血常規和肝腎功能均無明顯變化,治療過程均未齣現不良反應.結論:陰虛暘亢血瘀證型2級原髮性高血壓左室肥厚患者左室質量指數和血漿神經肽Y含量顯著高于健康人;在依那普利應用基礎上服用益心降壓膠囊具有較好的逆轉左室肥厚和降低血漿神經肽Y含量的作用.
배경:원발성고혈압인기적좌실비후시발생각충심혈관병발증구유독립작용적위험인자,역전좌실비후이성위당전고혈압치료적중요목표지일.혈장신경태Y유내피원성축혈관작용,통과대혈관내피세포적작용발휘대혈관서축공능적조절작용이삼여고혈압적발병화유지.목적:관찰익심강압효낭대음허양항혈어증형2급원발성고혈압좌실비후환자좌실질량지수급신경태Y함량적영향.설계:이환자위관찰대상,병례분석.단위:해방군제남군구총의원중의과;산동중의약대학부속의원내과.대상:선택2003-03/2005-08해방군제남군구총의원、산동중의약대학부속의원93례자원삼가본실험적음허양항혈어증형2급원발성고혈압좌실비후환자.채용수궤수자표장환자분위량조.관찰조62례,남40례,녀22례;년령46～70세,평균58.94세;병정2～19년,평균8.93년.대조조31례,남19례,녀12례;년령44～69세,평균59.27세;병정2.5～18년,평균9.11년.령설건강조30례,균래자건강체검인군.방법:량조환자균구복의나보리편,매차10 mg,매일1차.관찰조가복익심강압효낭(약물조성위:생지황、생수오、상기생、천우슬、구등、석결명、하고초、천마、모단피、적작약、지룡、천산룡등,안비례배방,제취농축,장입효낭,매립0.5 g,매극함생약4.65 g,유산동제남굉제당제약유한책임공사제공,비호:021214),매차5립,매일3차.량조료정균위24주.채용초성심동도의화방사면역분석법분별측정량조환자치료전후좌실질량지수화혈장신경태Y함량.동시측정건강조상술지표작대조.주요관찰지표:좌실질량지수화혈장신경태Y함량변화;혈압변화;불량사건급부반응.결과:93례환자균진입결과분석.①치료전관찰조화대조조환자좌실질량지수화혈장신경태Y함량균교건강조현저승고[(147.2±16.9),(146.7±17.2),(101.8±22.4)g/m2;(135.4±33.2),(133.8±31.1),(78.6±24.5)ng/L;P＜0.01];②치료24주후량조환자좌실질량지수화혈장신경태Y함량균현저강저,차관찰조우우대조조[(103.9±24.6),(122.6±19.9)g/m2;(82.9±25.2),(113.7±26.2)ng/L;P＜0.05～0.01].③관찰조치료후좌실질량지수화혈장신경태Y함량여건강조비교차이무현저성(P＞0.05),대조조잉고우건강조(P＜0.01).④관찰조화대조조수축압、서장압하강폭도비교차이무현저성[(137.4±12.8),(134.2±11.9)mm Hg;(80.1±8.3),(81.7±7.4)mm Hg,P＞0.05].량조환자치료전후혈상규화간신공능균무명현변화,치료과정균미출현불량반응.결론:음허양항혈어증형2급원발성고혈압좌실비후환자좌실질량지수화혈장신경태Y함량현저고우건강인;재의나보리응용기출상복용익심강압효낭구유교호적역전좌실비후화강저혈장신경태Y함량적작용.
BACKGROUND: Left ventricular hypertrophy induced by primary hyper tension is a risk factor which has a dependent effect on various cardiovas cular complications. Reversal left ventricular hypertrophy has been a key object for treating hypertension currently. Plasma neuropeptide Y has en dothelium-derived contracting blood vessel, and has adjusting effect on va somotor function through endothelial cell to participate in onset and main tenance of hypertension. OBJECTIVE: To investigate effect of yixin jiangya capsule on left ven tricular mass index (LVMI) and content of neuropeptide Y of primary grade 2 hypertensive patiepts with left ventricular hypertrophy of hyperactivity of yang due to yin deficiency blood stasis. DESIGN: Case analysis on the basis of patients. SETTING: Department of Traditional Chinese Medicine, General Hospital of Jinan Military Area Command of Chinese PLA; Department of Internal Medicine, Affiliated Hospital of Shandong University of Traditional Chi nese Medicine. PARTICIPANTS: Totally 93 primary grade 2 hypertensive patients with left ventricular hypertrophy of hyperactivity of yang due to yin deficiency blood stasis were selected from General Hospital of Jinan Military Area Command of Chinese PLA and Affiliated Hospital of Shandong University of Traditional Chinese Medicine from March 2003 to August 2005. All cases were divided into two groups according to random digital table. There were 62 cases in observational group including 40 males and 22 females aged from 46 to 70 years with mean age of 58.94 years and coursed from 2 to 19 years with mean course of 8.93 years. There were 31 cases in control group including 19 males and 12 females aged from 44 to 69 years with mean age of 59.27 years and coursed from 2.5 to 18 years with mean course of 9.11 years. Another 30 people were regarded as healthy group.METHODS: Patients in both groups were treated with enalaprol orally with 10 mg each time of once a day. Patients in observational group were also treated with yixin jiangya capsule (component: shengrlihuang, shengshouwu, sangjisheng, chuanniuxi, gouteng, shijueming, xiakucao, tianma,mudanpi, chishaoyao, dilong, chuanshanjia, etc. Mixed according to ratio,extracted, concentrated, made of capsule, 0.5 g/pill, 4.65 g/raw drug, provided by Shandong Jinan Hongjitang Pharmacy Limited-liability Company,batch number:. 021214), 5 pills once for 3 times every day. Courses in both groups were 24 weeks respectively. LVMI and content of neuropeptide Y were measured with ultrasonic cardiograph and radio-immunity analysis method before and after treatment. Meanwhile, indexes mentioned above were also measured in healthy group so as to regard as the controls.MAIN OUTCOME MEASURFS: LVMI, content of neuropeptide Y,changes of blood pressure, adverse events and side effects.RESULTS: Totally 93 patients entered the final analysis. ① LVMI and content of neuropeptide Y were increased both observational group and control group before treatment [(147.2±16.9), (146.7±17.2), (101.8±.22.4) g/m2;(135.4±33.2), (133.8±31.1), (78.6±24.5) ng/L.; P ＜ 0.01]. ② LVMI and content of neuropeptide Y were decreased both observational group and control group after 24-week treatment, and those in observational group were superior to those in control group [(103.9±24.6), (122.6±19.9) g/m2;(82.9±25.2), (113.7±26.2) ng/L; P ＜ 0.05-0.01]. ③ LVMI and content of neuropeptide Y in observational group were not significantly different from those in healthy group increased both in observational group and control group after treatment (P.＞ 0.05), and those in control group were higher than those in healthy group (P ＜ 0.01). ④ Descent levels of systolic pressure and diastolic pressure were not significantly different between observational group and control group [(137.4±12.8), (134.2:t:11.9) mm Hg;(80.1±8.3), (81.7±7.4) mm Hg, P ＞ 0.05]. Blood routine and liver-kidney function were not changed obviously both groups before and after treatment, and side effect was not observed during the process.CONCLUSION: LVMI and content of neuropeptide Y of primary grade 2 hypertensive patients with left ventricular hypertrophy of hyperactivity of yang due to yin deficiency blood stasis are higher than those of healthy people. Yixin jiangya capsule can deteriorate left ventricular hypertrophy and decrease the content of neuropeptide Y on the basis of application of enalaprol.
