天麻钩藤汤加减治疗肝阳上亢型原发性高血压疗效观察及对神经递质节律的影响

目的:观察天麻钩藤汤加减治疗原发性高血压肝阳上亢型患者的临床治疗效果及对神经递质节律影响。方法:选取2017年1月至2018年1月郑州市第六人民医院收治的原发性高血压肝阳上亢型患者100例作为研究对象,将达到病例选择范围的93例患者按照治疗药物不同分为对照组(n=44)和观察组(n=49)。对照组采取西药基础治疗,观察组采用西药基础治疗+天麻钩藤汤加减治疗。疗程结束后,观察2组血压水平、神经递质节律、中医症状积分。结果:1)观察组晨起平均收缩压、24 h平均收缩压、夜间平均收缩压、晨起平均舒张压、夜间平均舒张压、24 h平均舒张压明显低于对照组(P<0.05);2)观察组神经肽Y、神经元特异性烯醇化酶、血管加压素、强啡肽-A显著低于对照组(P<0.05),P物质、脑源性神经营养因子显著高于对照组(P<0.05);3)观察组甘氨酸、γ-氨基丁酸显著低于对照组(P<0.05),天冬氨酸、谷氨酸显著高于对照组(P<0.05);4)观察组治疗后中医症状总积分显著低于对照组(P<0.05)。结论:针对原发性高血压肝阳上亢型患者,在西药治疗基础上,增加天麻钩藤汤加减治疗,能够有效促进患者神经递质节律的恢复,调节血压,同时对降低中医症状积分,值得临床推广应用。

Clinical Efficacy Observation on Modified Tianma Gouteng Decoction on Primary Hypertension with Liver Yang Hyperactivity Syndrome and Its Effects on Neurotransmitter Rhythm

Objective:To explore the effects of Tianma Gouteng Decoction on clinical treatment and neurotransmitter rhythm in patients with primary hypertension with hepatoyang hyperactivity.Methods:From January 2017 to January 2018,100 cases of primary hypertension(liver yang hyperactivity syndrome)in the Sixth People′s Hospital of Zhengzhou were selected.93 patients within the scope of medical cases were divided into an observation group(49 cases)and a control group(44 cases).The control group adopted western medicine basic treatment.The observation group was treated with western medicine basic treatment and modified Tianma Gouteng Decoction.After the treatment,blood pressure level,neurotransmitter rhythm and TCM symptom score of the 2 groups were observed.Results:1)The blood pressure in the observation group were significantly lower than the control group(P<0.05).2)NPY,NSE,VAP,Dny-A of the observation group were significantly lower than that of the control group,while SP and BDNF were significantly higher than that of the control group(P<0.05).3)Gly,GABA of the observation group were significantly lower than that of the control group,and Asp and Glu were significantly higher than that of the control group(P<0.05).4)The total score of TCM symptom score of the observation group after treatment was significantly lower than that of the control group(P<0.05).Conclusion:For patients with primary hypertension of liver yang hyperactivity syndrome,on the basis of western medicine,adding of modified Tianma Gouteng Decoction can effectively promote the recovery of patients with neurotransmitters rhythm,adjust blood pressure.At the same time,it has its significant effect to reduce the TCM symptom integral,which is worthy of clinical popularization and application.