通心络胶囊合培哚普利治疗老年高血压病临床的研究.pdfVIP

2.8 安全性监测··········································23 3 讨论 ····················································23 3.1 通心络胶囊治疗老年高血压病作用机制·············23 3.2 培哚普利降压机制及疗效 ································29 3.3 通心络胶囊合培哚普利的降压疗效分析 ·············30 3.4 通心络胶囊合培哚普利对 NO 、ET 的作用 ···········31 3.5 通心络胶囊合培哚普利改善症状的疗效分析 ········32 3.6 安全性监测分析 ·········································33 4 小结····················································33 4.1 本研究情况的总结 ·······································33 4.2 本研究的创新点 ·········································33 4.3 存在的问题及今后努力的方向 ·····························34 参考文献 ··················································34 致 谢 ··················································40 攻读学位期间发表的学术论文目录 ·······················41 作者声明 ··················································42 个人简历 ··················································43 中 文 摘 要 目 的：本研究是根据祖国医学对高血压病的病因病机、辨证及治疗 的有关理论，在深入探讨中医治疗进展的基础上，认为气虚血瘀、络脉 不畅是老年高血压病的重要病机，益气活血通络法是治疗该病的重要治 法。联合使用通心络胶囊与培哚普利，观察对老年高血压病的临床疗效, 探索联用的降血压作用机制, 为确立科学、有效的高血压病中西医结合 规范化治疗方案提供有价值的临床研究依据。 方 法：将60例气虚血瘀证老年高血病患者随机分为两组，中西药组 和西药组，每组各30例。中西药组口服通心络胶囊（3粒，t.i.d ）和培哚 普利（商品名雅施达,由施维雅制药有限公司生产）；西药组口服培哚普 利，4mg ，Qd。两组疗程均为4周。同时收集30例健康人作为对照组。疗 程结束后，观察治疗前后血压、证候疗效及血浆中ET-1和NO 的变化。 结 果：1.治疗4周后，两组患者血压较治疗前显著降低(P 0.01),各 组间比较，中西药组优于西药组(P0.05)。2.经治疗后，两组患者血浆 ET-1水平均较治疗前明显下降（P0.05 ），NO明显升高（P0.05 ），中西 药组优于西药组(P0.05)。3.中西药组和西药组的证候疗效总有效率分 别为93.33%和70%，中西药组优于西药组(P0.05)。 结 论：通心络胶囊与培哚普利联用具有良好降压作用，并能呈现明 显改善气虚血瘀型老年高血压病患者的临床症状，升高血清NO 的水平， 降低血浆ET-1 的水平，具有改善血管内皮功能的作用，疗效优于单纯使 用培哚普利。 关键词：老年高血压病；通心络胶囊；一氧化氮；血管内皮素 1 Clinical study on Treating senile hypertension with Tongxinluo Capsule and perindopril ABSTRACT Objective: This research is based on some theories of Chinese medicine about ET-1iology, pathogenesis, differentiation and