中药苍薏饮治疗痰湿体质高血压患者的临床研究

doi:10.3760/cma.j.issn.1007-1245.2024.06.029

摘要/Abstract

摘要：

目的　观察中药苍薏饮在改善及治疗痰湿型高血压患者中的应用效果。方法　选择2023年1月至9月广州市越秀区中医医院收治的96例高血压患者，体质辨识均为痰湿体质。采用随机数字表法随机分成两组，每组48例。对照组男25例，女23例；年龄（57.91±10.78）岁；病程（5.62±1.25）年；给予常规临床治疗。中药组男28例，女20例；年龄（58.37±11.09）岁；病程（5.59±1.21）年；在常规治疗基础上增加中药苍薏饮治疗。两组均连续治疗12周。比较两组患者痰湿体质症状、血压、血脂、炎症因子水平及生活质量情况。采用独立样本t检验、配对t检验和χ²检验。结果　治疗后，中药组总有效率［89.58%（43/48）］高于对照组［72.92%（35/48）］，差异有统计学意义（χ²=4.376，P=0.036）；治疗后，中药组胸闷腹胀、身体沉重、口黏痰多、舌苔厚腻症状评分均低于对照组［（0.64±0.17）分比（2.37±0.41）分，（0.51±0.12）分比（2.29±0.15）分，（0.66±0.15）分比（2.18±0.49）分，（0.67±0.25）分比（2.33±0.47）分］（均P<0.05）；治疗后，中药组收缩压（SBP）、舒张压（DBP）、肿瘤坏死因子-α（TNF-α）、白细胞介素6（IL-6）水平均低于对照组［（114.65±13.49）mmHg比（123.58±14.25）mmHg（1 mmHg=0.133 kPa），（79.54±9.21）mmHg比（85.09±10.38）mmHg，（37.19±4.87）ng/L比（45.18±5.33）ng/L，（21.95±3.28）ng/L比（27.38±3.70）ng/L］（均P<0.05）；治疗后，中药组总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）水平均低于对照组［（4.27±1.08）mmol/L比（6.18±1.15）mmol/L，（1.28±0.29）mmol/L比（2.05±0.34）mmol/L，（2.51±0.59）mmol/L比（3.71±0.73）mmol/L］，高密度脂蛋白胆固醇（HDL-C）水平高于对照组［（1.97±0.35）mmol/L比（1.61±0.38）mmol/L］（均P<0.05）；治疗后，中药组世界卫生组织生活质量简表（WHOQOL-BREF）中生理、心理、环境及社会维度评分均高于对照组［（86.93±8.17）分比（58.34±8.32）分，（83.27±5.19）分比（59.52±5.34）分，（79.84±5.47）分比（55.87±5.29）分，（78.65±5.41）分比（60.41±5.82）分］（均P<0.05）。结论　中药苍薏饮可改善痰湿体质高血压患者的体质症状，调节患者血压、血脂、炎症因子水平，提高患者生活质量，值得推广和应用。

关键词:

高血压, 痰湿体质, 中药苍薏饮, 生活质量

Abstract:

Objective　To explore the effect of Chinese medicine Cangyi Yin in the treatment of hypertensive patients with phlegm-dampness constitution type. Methods　A total of 96 hypertensive patients with phlegm-dampness constitution type treated in Guangzhou Yuexiu District Traditional Chinese Medicine Hospital from January to September 2023 were collected as the research objects, and were divided into two groups by the random number table method, with 48 patients in each group. There were 25 males and 23 females in the control group, aged (57.91±10.78) years, and the course of disease was (5.62±1.25) years. There were 28 males and 20 females in the TCM group, aged (58.37±11.09) years, and the course of disease was (5.59±1.21) years. The control group was given routine clinical treatment, and the TCM group was given Chinese medicine Cangyi Yin on the basis of routine treatment for 12 weeks. The symptoms of phlegm-dampness constitution, levels of blood pressure, blood lipids, and inflammatory factors, and qualities of life of the two groups were compared and analyzed. Independent sample t test was used for inter-group comparison of the measurement data, paired t test was used for intra-group comparison of the measurement data, and χ² test was used for the count data. Results　After treatment, the total effective rate of the TCM group [89.58% (43/48)] was higher than that of the control group [72.92% (35/48)], with a statistically significant difference (χ²=4.376, P=0.036). After treatment, the symptom scores of chest tightness and abdominal distension, heavy body, mucus and phlegm at the mouth, and thick and greasy tongue coating in the TCM group were lower than those in the control group [(0.64±0.17) points vs. (2.37±0.41) points, (0.51±0.12) points vs. (2.29±0.15) points, (0.66±0.15) points vs. (2.18±0.49) points, (0.67±0.25) points vs. (2.33±0.47) points] (all P<0.05). After treatment, the levels of systolic blood pressure (SBP), diastolic blood pressure (DBP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) in the TCM group were lower than those in the control group [(114.65±13.49) mmHg vs. (123.58±14.25) mmHg (1 mmHg = 0.133 kPa), (79.54±9.21) mmHg vs. (85.09±10.38) mmHg, (37.19±4.87) ng/L vs. (45.18±5.33) ng/L, (21.95±3.28) ng/L vs. (27.38±3.70) ng/L] (all P<0.05). After treatment, the levels of total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) in the TCM group were lower than those in the control group [(4.27±1.08) mmol/L vs. (6.18±1.15) mmol/L, (1.28±0.29) mmol/L vs. (2.05±0.34) mmol/L, (2.51±0.59) mmol/L vs. (3.71±0.73) mmol/L], while the level of high-density lipoprotein cholesterol (HDL-C) was higher than that in the control group [(1.97±0.35) mmol/L vs. (1.61±0.38) mmol/L] (all P<0.05). After treatment, the scores of physiological, psychological, environmental, and social dimensions of the WHOQOL-BREF in the TCM group were higher than those in the control group [(86.93±8.17) points vs. (58.34±8.32) points, (83.27±5.19) points vs. (59.52±5.34) points, (79.84±5.47) points vs. (55.87±5.29) points, (78.65±5.41) points vs. (60.41±5.82) points] (all P<0.05). Conclusion　The traditional Chinese medicine Cangyi Yin can improve the physical symptoms of hypertensive patients with phlegm-dampness constitution type, regulate the levels of blood pressure, blood lipids, and inflammatory factors, and improve their quality of life, which is worth promoting and applying.

Key words:

Hypertension, Phlegm-dampness constitution, Chinese medicine Cangyi Yin, Quality of life

梁志乐陈国成潘林平王小艳唐灿洪赖满刘王媛媛.

中药苍薏饮治疗痰湿体质高血压患者的临床研究 [J]. 国际医药卫生导报, 2024, 30(6): 1020-1024.

Liang Zhile, Chen Guocheng, Pan Linping, Wang Xiaoyan, Tang Canhong, Lai Manliu, Wang Yuanyuan.

Clinical study on Chinese medicine Cangyi Yin in the treatment of hypertensive patients with phlegm-dampness constitution type [J]. International Medicine and Health Guidance News, 2024, 30(6): 1020-1024.

参考文献

[1] Chan RJ, Helmeczi W, Hiremath SS. Revisiting resistant hypertension: a comprehensive review[J]. Intern Med J, 2023, 53(10):1739-1751. DOI: 10.1111/imj.16189.
[2] 中国心血管健康与疾病报告编写组.中国心血管健康与疾病报告2021概要[J].心脑血管病防治,2022,22(4):20-36,40.DOI:10.3969/j.issn.1009-816x.2022.04.002.
[3] 赵连友.构建我国全社会参与高血压防控体系的思考[J].中华高血压杂志,2022,30(12):1101-1102.DOI:10.16439/j.issn.1673-7245.2022.12.001.
[4] 庄捷,殷萧然,王化云,等.眩晕病中医辨证论治浅探[J].世界最新医学信息文摘,2021,21(61):40-41,120.DOI:10.3969/j.issn.1671-3141.2021.61.018.
[5] 李鹤,张锐,杨清馨,等.中医体质类型与高血压相关性研究的Meta分析[J].济宁医学院学报,2020,43(1):54-58.DOI:10.3969/j.issn.1000-9760.2020.01.013.
[6] 赵梦茹,王睿瑞,任光为,等.社区老年高血压病患者的中医体质类型及相关危险因素分析[J].安徽中医药大学学报,2020,39(6):13-17.DOI:10.3969/j.issn.2095-7246.2020. 06.005.
[7] 中国高血压防治指南修订委员会,高血压联盟(中国,中华医学会心血管病学分会中国医师协会高血压专业委员会,等.中国高血压防治指南(2018年修订版)[J].中国心血管杂志,2019,24(1):24-56.DOI:10.3969/j.issn.1007-5410.2019. 01.002.
[8] 中华中医药学会.ZYYXH/T157-2009:中医体质分类与判定[S].北京:中国中医药出版社,2009.
[9] 李润,李柳娜,王梦琪,等.子午流注理论下的刮痧干预联合情志护理对痰湿壅盛证原发性高血压患者的影响[J].国际医药卫生导报,2023,29(3):404-408.DOI:10.3760/cma.j.issn.1007-1245.2023.03.024.
[10] 陆柳营,杨连招,陈玲,等.社区老年高血压患者痰湿体质分布现状及影响因素分析[J].上海护理,2021,21(10):33-38.DOI:10.3969/j.issn.1009-8399.2021.10.008.
[11] 陈静芝,王飞,章莹,等.高血压病与痰湿体质的相关性研究进展[J].中医临床研究,2022,14(20):127-130.DOI:10.3969/j.issn.1674-7860.2022.20.042.
[12] 张小庆,孙丹杰.基于体病相关论探讨化湿祛痰颗粒对高血压痰湿质疗效及炎症标志物影响[J].中国现代医生,2023,61(6):90-94.DOI:10.3969/j.issn.1673-9701.2023.06.023.
[13] 张硕,陈震霖,唐于平.中医药辨治高血压的认识与发展[J].世界科学技术-中医药现代化,2020,22(12):4139-4146.DOI:10.11842/wst.20200206001.
[14] 岳思冉,谭宜云,谢峰,等.上海社区老年人非酒精性脂肪性肝病、高血压共病机制及中医体质分布规律研究[J].上海中医药杂志,2022,56(5):39-43.DOI:10.16305/j.1007- 1334.2022.2109082.
[15] 李八统,文莺颖,杨年华,等.基于"五脏同调"理论探讨中医食疗调理痰湿体质高血压的作用[J].国际医药卫生导报,2022,28(10):1426-1430.DOI:10.3760/cma.j.issn.1007- 1245.2022.10.023.
[16] 唐宗海.血证论[M].北京:人民卫生出版社,2017.
[17] 李斌,冉小库,孙云超,等.茯苓对脾虚水湿内停大鼠的健脾利水药效物质研究[J].世界中医药,2015,10(12):1859-1867.DOI:10.3969/j.issn.1673-7202.2015.12.007.
[18] Wu ZL, Ren H, Lai WY, et al. Sclederma of Poria cocos exerts its diuretic effect via suppression of renal aquaporin-2 expression in rats with chronic heart failure[J]. J Ethnopharmacol, 2014, 155(1):563-571. DOI: 10.1016/j.jep.2014.05.054.
[19] 李玲玲,李开,张月圆,等.薏苡仁醇溶蛋白源小分子肽生物学活性研究[J].中医药学报,2017,45(5):21-25.DOI:10.3969/j.issn.1002-2392.2017.05.006.
[20] Bunbupha S, Apaijit K, Potue P, et al. Hesperidin inhibits L-NAME-induced vascular and renal alterations in rats by suppressing the renin-angiotensin system, transforming growth factor-β1, and oxidative stress[J]. Clin Exp Pharmacol Physiol, 2021, 48(3):412-421. DOI: 10.1111/1440-1681.13438.
[21] de Souza P, da Silva RCV, Mariano LNB, et al. Diuretic and natriuretic effects of hesperidin, a flavanone glycoside, in female and male hypertensive rats[J]. Plants (Basel), 2022, 12(1):25. DOI: 10.3390/plants12010025.
[22] Ortiz-Andrade R, Araujo León JA, Sánchez-Salgado JC, et al. Citroflavonoids as romising agents for drug discovery in diabetes and hypertension: a systematic review of experimental studies[J]. Molecules, 2022, 27(22):7933. DOI: 10.3390/molecules27227933.
[23] 王馨平,聂黎行,康帅,等.紫苏叶的化学成分、药理活性和质量控制研究进展[J].中国药事,2023,37(10):1193-1212.DOI:10.16153/j.1002-7777.2023.10.011.
[24] 钟萍,汪镇朝,刘英孟,等.紫苏叶挥发油化学成分及其药理作用研究进展[J].中国实验方剂学杂志,2021,27(13):215-225.DOI:10.13422/j.cnki.syfjx.20211205.
[25] 黄博,张明雪.基于数据挖掘研究张明雪教授治疗冠心病合并高血压用药规律[J].实用中医内科杂志,2022,36(6):1-4,后插1.DOI:10.13729/j.issn.1671-7813.Z20211082.
[26] 三黄泻心汤及其组成生药的降压作用[J].国外医学(中医中药分册),2003,25(1):55.
[27] 文清华,文洪博,蒋祖红,等.甘草附子汤加减治疗对风寒湿阻证类风湿关节炎患者中医临床症状及血清基质金属蛋白酶3、骨保护素和核因子-κB受体活化因子配体水平的影响[J].中医临床研究,2023,15(8):116-120.DOI:10.3969/j.issn.1674-7860.2023.08.025.