CAJ | 학술논문

目的：以天麻钩藤饮对颈-股动脉脉搏波速度（C-FPWV）、血流介导的血管舒张反应（FMD）和症状分级为主要观察指标，探索天麻钩藤饮改善血管顺应性和血管内皮功能的功效。方法按照诊断标准、纳入标准和排除标准选择原发性高血压1级（肝阳上亢型）患者60例，随机分成2组，中药（中西药＝氢氯噻嗪＋天麻钩藤饮）治疗组（30例），常规（西药＝氢氯噻嗪）治疗组（30例），疗程均为12周，并与正常健康人（30例）比较。结果与正常组比较，高血压患者的C-FPWV加快，中药治疗组C-FPWV较治疗前显著下降（P<0.01），常规治疗组C-FPWV较治疗前无差异（P>0.05），两组比较，中药治疗组C-FPWV下降幅度显著优于常规治疗组（P<0.01）。与正常组比较，高血压患者的FDM显著低于血压正常组，中药治疗组FDM较治疗前显著升高（P<0.01），常规治疗组FMD较治疗前升高无差异（P>0.05），两组比较，中药治疗组FDM升高幅度显著优于常规治疗组（P<0.01）。治疗前后血压及症状分级变化，治疗组与对照组治疗前后血压及症状分级较治疗前显著下降（P<0.01），两组比较，治疗组治疗血压及症状分级下降幅度显著优于对照组（P<0.01）。结论天麻钩藤饮与降压药联合，可有效改善血管顺应性及内皮功能，较单用降压药具有疗效，且可以更好地稳定血压与改善症状。
목적：이천마구등음대경-고동맥맥박파속도（C-FPWV）、혈류개도적혈관서장반응（FMD）화증상분급위주요관찰지표，탐색천마구등음개선혈관순응성화혈관내피공능적공효。방법안조진단표준、납입표준화배제표준선택원발성고혈압1급（간양상항형）환자60례，수궤분성2조，중약（중서약＝경록새진＋천마구등음）치료조（30례），상규（서약＝경록새진）치료조（30례），료정균위12주，병여정상건강인（30례）비교。결과여정상조비교，고혈압환자적C-FPWV가쾌，중약치료조C-FPWV교치료전현저하강（P<0.01），상규치료조C-FPWV교치료전무차이（P>0.05），량조비교，중약치료조C-FPWV하강폭도현저우우상규치료조（P<0.01）。여정상조비교，고혈압환자적FDM현저저우혈압정상조，중약치료조FDM교치료전현저승고（P<0.01），상규치료조FMD교치료전승고무차이（P>0.05），량조비교，중약치료조FDM승고폭도현저우우상규치료조（P<0.01）。치료전후혈압급증상분급변화，치료조여대조조치료전후혈압급증상분급교치료전현저하강（P<0.01），량조비교，치료조치료혈압급증상분급하강폭도현저우우대조조（P<0.01）。결론천마구등음여강압약연합，가유효개선혈관순응성급내피공능，교단용강압약구유료효，차가이경호지은정혈압여개선증상。
Objective To investigate the effect of Tianma Gouteng Decoction of carotid femoral arterial pulse wave velocity(c-fpwv),and flow mediated vascular as the main outcome measures were used to assess endothelial(FMD)and symptom classification,in order to explore the Tianma Gouteng Decoction to improve vascular compliance and endothelial function effect.Methods According to the diagnostic criteria, inclusion criteria and exclusion of selection criteria for primary hypertension 1 level(liver yang hyperactivity type)of 60 cases of patients were randomly divided into two groups,TCM(traditional Chinese and Western medicine=hydrogen chlorine thiazide+Tianma Gouteng Decoction)treatment group(30 cases), conventional(western medicine=hydrochlorothiazide) treatment group (30 cases),a course of 12 weeks,and compared with normal healthy people (30 cases).ResultsCompared with the normal group,the C-FPWV of patients with hypertension was accelerated. The C-FPWV of Chinese medicine treatment group was significantly decreased(P< 0.01), and the C-FPWV in the conventional treatment group was not significantly different (P> 0.05),and the C-FPWV in the Chinese medicine treatment group was significantly better than that in the conventional treatment group(P< 0.01). Compared with normal group, FDM was significantly lower in hypertensive patients than that in normal group(P< 0.01),and FMD in the conventional treatment group was not significantly different(P> 0.05),the two groups were significantly higher than those in the conventional treatment group(P< 0.01). Before and after treatment,blood pressure and symptom classification were changed. The blood pressure and symptom classification before and after treatment were significantly decreased(P< 0.01),the two groups compared with the control group was significantly different(P< 0.01).Conclusion Tianma Gouteng Decoction and antihypertensive drug can be effective in improving vascular adaptation and endothelial function than single use of antihypertensive drugs and can better stabilize blood pressure,and improving symptoms.