中国临床康复
中國臨床康複
중국림상강복
CHINESE JOURNAL OF CLINICAL REHABILITATION
2004年
30期
6808-6810
,共3页
高血压/中药疗法%膏剂%气虚%血瘀%肾上腺髓质素/代谢%内皮素/代谢%血管紧张素Ⅱ/代谢
高血壓/中藥療法%膏劑%氣虛%血瘀%腎上腺髓質素/代謝%內皮素/代謝%血管緊張素Ⅱ/代謝
고혈압/중약요법%고제%기허%혈어%신상선수질소/대사%내피소/대사%혈관긴장소Ⅱ/대사
背景:原发性高血压患者血浆肾上腺髓质素(adrenomedullin,ADM)、内皮素、血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)水平升高,但抗高血压治疗对其影响尚未十分了解.目的:探讨益脉降压流浸膏对老年气虚血瘀证型Ⅱ期原发性高血压患者血管活性物质的影响.设计:以诊断为依据,随机对照试验.地点、对象和方法:病例来源于济南军区总医院及山东中医药大学附属医院,实验在山东中医药大学附属医院中心实验室进行.入选的60例患者均系1999-03/09期间观察的患者,其中住院患者36例,门诊患者24例.纳入标准:年龄≥60岁,符合1993年WHO/ISH高血压诊断标准,排除标准:排除继发性高血压、糖尿病、冠心病、肝肾疾病及内分泌疾病,剔除Ⅰ期和Ⅲ期原发性高血压,同时按中国中西医结合研究会制定的中医虚证辨证标准及血瘀证诊断标准辨证为气虚血瘀证型者,按随机数字法分为两组.治疗组(益脉降压流浸膏治疗)30例,男17例,女13例;对照组(卡托普利治疗)30例,男18例,女12例.另设健康对照组25例,为同期来济南军区总医院的健康体检者,并为自愿受试者,男14例,女11例.采用放射免疫法测定60例老年气虚血瘀证型Ⅱ期原发性高血压患者治疗前后及25例老年健康人(健康对照组)血浆ADM、内皮素、AngⅡ水平进行比较.结果:治疗组和对照组患者治疗前血浆ADM[(67.8±16.1),(69.6±14.3)ng/L]、内皮素[(72.1±10.4),(70.9±8.9)ng/L]、AngⅡ[(172.5±40.3),(165.2±44.9)μg/L]水平均比健康对照组[(43.7±7.3),(43.8±6.8)ng/L和(82.9±18.6)μg/L]高(t=6.915～11.643,P＜0.01);治疗后治疗组患者血浆ADM、内皮素、AngⅡ水平显著低于治疗前(t=5.113,6.742,5.314,P＜0.01),其中降低内皮素作用优于对照组(t=6.186,P＜0.01),而降低AngⅡ作用弱于对照组(t=6.794,P＜0.01).治疗组和对照组治疗后血压比较,差异无显著性意义(P＞0.05)结论:老年气虚血瘀证型Ⅱ期原发性高血压患者存在血浆ADM、内皮素、AngⅡ水平增高;益脉降压流浸膏具有良好的降低ADM、内皮素、AngⅡ作用.
揹景:原髮性高血壓患者血漿腎上腺髓質素(adrenomedullin,ADM)、內皮素、血管緊張素Ⅱ(angiotensinⅡ,AngⅡ)水平升高,但抗高血壓治療對其影響尚未十分瞭解.目的:探討益脈降壓流浸膏對老年氣虛血瘀證型Ⅱ期原髮性高血壓患者血管活性物質的影響.設計:以診斷為依據,隨機對照試驗.地點、對象和方法:病例來源于濟南軍區總醫院及山東中醫藥大學附屬醫院,實驗在山東中醫藥大學附屬醫院中心實驗室進行.入選的60例患者均繫1999-03/09期間觀察的患者,其中住院患者36例,門診患者24例.納入標準:年齡≥60歲,符閤1993年WHO/ISH高血壓診斷標準,排除標準:排除繼髮性高血壓、糖尿病、冠心病、肝腎疾病及內分泌疾病,剔除Ⅰ期和Ⅲ期原髮性高血壓,同時按中國中西醫結閤研究會製定的中醫虛證辨證標準及血瘀證診斷標準辨證為氣虛血瘀證型者,按隨機數字法分為兩組.治療組(益脈降壓流浸膏治療)30例,男17例,女13例;對照組(卡託普利治療)30例,男18例,女12例.另設健康對照組25例,為同期來濟南軍區總醫院的健康體檢者,併為自願受試者,男14例,女11例.採用放射免疫法測定60例老年氣虛血瘀證型Ⅱ期原髮性高血壓患者治療前後及25例老年健康人(健康對照組)血漿ADM、內皮素、AngⅡ水平進行比較.結果:治療組和對照組患者治療前血漿ADM[(67.8±16.1),(69.6±14.3)ng/L]、內皮素[(72.1±10.4),(70.9±8.9)ng/L]、AngⅡ[(172.5±40.3),(165.2±44.9)μg/L]水平均比健康對照組[(43.7±7.3),(43.8±6.8)ng/L和(82.9±18.6)μg/L]高(t=6.915～11.643,P＜0.01);治療後治療組患者血漿ADM、內皮素、AngⅡ水平顯著低于治療前(t=5.113,6.742,5.314,P＜0.01),其中降低內皮素作用優于對照組(t=6.186,P＜0.01),而降低AngⅡ作用弱于對照組(t=6.794,P＜0.01).治療組和對照組治療後血壓比較,差異無顯著性意義(P＞0.05)結論:老年氣虛血瘀證型Ⅱ期原髮性高血壓患者存在血漿ADM、內皮素、AngⅡ水平增高;益脈降壓流浸膏具有良好的降低ADM、內皮素、AngⅡ作用.
배경:원발성고혈압환자혈장신상선수질소(adrenomedullin,ADM)、내피소、혈관긴장소Ⅱ(angiotensinⅡ,AngⅡ)수평승고,단항고혈압치료대기영향상미십분료해.목적:탐토익맥강압류침고대노년기허혈어증형Ⅱ기원발성고혈압환자혈관활성물질적영향.설계:이진단위의거,수궤대조시험.지점、대상화방법:병례래원우제남군구총의원급산동중의약대학부속의원,실험재산동중의약대학부속의원중심실험실진행.입선적60례환자균계1999-03/09기간관찰적환자,기중주원환자36례,문진환자24례.납입표준:년령≥60세,부합1993년WHO/ISH고혈압진단표준,배제표준:배제계발성고혈압、당뇨병、관심병、간신질병급내분비질병,척제Ⅰ기화Ⅲ기원발성고혈압,동시안중국중서의결합연구회제정적중의허증변증표준급혈어증진단표준변증위기허혈어증형자,안수궤수자법분위량조.치료조(익맥강압류침고치료)30례,남17례,녀13례;대조조(잡탁보리치료)30례,남18례,녀12례.령설건강대조조25례,위동기래제남군구총의원적건강체검자,병위자원수시자,남14례,녀11례.채용방사면역법측정60례노년기허혈어증형Ⅱ기원발성고혈압환자치료전후급25례노년건강인(건강대조조)혈장ADM、내피소、AngⅡ수평진행비교.결과:치료조화대조조환자치료전혈장ADM[(67.8±16.1),(69.6±14.3)ng/L]、내피소[(72.1±10.4),(70.9±8.9)ng/L]、AngⅡ[(172.5±40.3),(165.2±44.9)μg/L]수평균비건강대조조[(43.7±7.3),(43.8±6.8)ng/L화(82.9±18.6)μg/L]고(t=6.915～11.643,P＜0.01);치료후치료조환자혈장ADM、내피소、AngⅡ수평현저저우치료전(t=5.113,6.742,5.314,P＜0.01),기중강저내피소작용우우대조조(t=6.186,P＜0.01),이강저AngⅡ작용약우대조조(t=6.794,P＜0.01).치료조화대조조치료후혈압비교,차이무현저성의의(P＞0.05)결론:노년기허혈어증형Ⅱ기원발성고혈압환자존재혈장ADM、내피소、AngⅡ수평증고;익맥강압류침고구유량호적강저ADM、내피소、AngⅡ작용.
BACKGROUND: Concentrations of adrenomedullin(ADM), endothelin and angiotensin Ⅱ (Ang- Ⅱ) were found increased in patients with essential hypertension, however the influence of anti-hypertension treatment on them had still been uncertain.OBJECTIVE:To explore the influence of yimai jiangya fluid extract on adrenomedullin, endothelin and Ang- Ⅱ of the elders with stage Ⅱ essential hypertension of qi deficiency and blood stasis.DESIGN: Clinical randomized controlled trial.SETTING, PARTICIPANTS and METHODS: Patients were all from Jinan Military General Hospital and Affiliated Hospital of Shandong University of Traditional Chinese Medicine, and the experiment was performed at the Center Laboratory. Of all sixty patients from March to September 1999, thirty-six cases were in-patients and the other 24 were outpatients. Enrolling criteria: Patients were not less than 60 years old and accorded with the International Society of Hypertension(ISH) diagnostic standard for hypertension by WHO in 1993. Excluding criteria: Patients with secondary hypertension, diabetes mellitus, coronary disease, liver and kidney diseases and endocrine disorders, and stage Ⅰ and Ⅲ essential hypertension were excluded;meanwhile qi deficiency and blood stasis were confirmed according to the syndrome differentiation criteria by Chinese Association of the Integration of Traditional and Western Medicine. Sixty cases were randomly divided as treatment group(TG) subjected to yimai jiangya fluid extract( n = 30, consists of 17 males and 13 females) and control group(CG) treated with capital ( n = 30 consists of 18 males and 12 females). Twenty-five healthy volunteers consisting of 14 males and 11 females from Jinan Military General Hospital made up healthy control group(HC) . The contents of plasma ADM, endothelin and Ang- Ⅱ of patients in TG and CG were determined by radioimmunoassay after treatment and compared with those of HC.RESULTS: Mean contents of ADM, endothelin and Ang Ⅱ in TG and CG were (67.8 ± 16. 1) ng/L, (72. 1 ± 10.4) pg/L, and(172.5 ±40.3) ng/L; and (69. 6 ± 14. 3) ng/L (70.9 ± 8.9) ng/L and(165.2 ± 44.9) μg/L, respectively, which were higher than those(43.7 ± 7.3) ng/L, (43.8 ± 6. 8) ng/L and (82. 9 ± 18.6) μg/L respectively in HC, ( t = 6.915 - 11. 643, P ＜ 0.01).And yimai jiangya fluid extract could markedly decrease the contents of three items(t = 5. 113, 6. 742, 5. 314; P ＜ 0.01), the effect of it was stronger than that of capital for endothelin( t = 6. 186, P ＜ 0. 01), and weaker for Ang- Ⅱ( t = 6. 794, P ＜ 0. 01 ). There was no statistical difference between treatment group and control group( P ＞ 0. 05) in blood prossure (BP) change after treatment.CONCLUSION: The levels of plasma ADM, endothelin and Aug Ⅱ increased in elder patients with stage Ⅱ essential hypertension of qi deficiency and blood stasis, which could be decreased by yimai jiangya fluid extract.
