【作者】 宋观礼；

【导师】 郭伟星；

【作者基本信息】 山东中医药大学 ， 中医内科学， 2011， 博士

【摘要】 目的:①综合评价益肾降压颗粒治疗老年高血压病肾气亏虚证的临床疗效;②观察老年高血压病肾气亏虚证性激素水平的变化及益肾降压颗粒对老年高血压病肾气亏虚证性激素水平的影响。方法:①收集老年高血压病肾气亏虚证临床病例72例,采用分层随机分组设计方法,利用随机数字表分为治疗组和对照组,治疗组给予益肾降压颗粒治疗,对照组给予复方降压片治疗,分别于治疗前及治疗后7d、14d、28d检测偶测血压变化,治疗前后动态血压变化、血脂血糖变化、心电图变化、中医症状评分变化、证候积分变化及患者生存质量变化,综合评价益肾降压颗粒的临床疗效。②收集30例健康老年人,其中男女各15例,作为正常对照组,检测其性激素水平（E₂, T, FSH, LH, T/E₂）。检测试验组30例（男女各15例）老年高血压病肾气亏虚证病人治疗前后性激素水平（E₂, T, FSH, LH, T/E₂）,总结老年高血压病肾气亏虚证性激素水平的变化及益肾降压颗粒对老年高血压病肾气亏虚证性激素水平的影响。结果:①益肾降压颗粒能够有效、平稳地降低血压,改善心肌缺血,纠正血脂和血糖代谢紊乱,同时还能改善患者的临床症状,提高患者的生存质量,无副作用及不良反应。②较健康老年人,男性老年高血压肾气亏虚证患者T水平及T/E₂比值均明显降低;女性老年高血压肾气亏虚证患者E₂水平明显降低,T/E₂比值升高。经益肾降压颗粒治疗后,男性老年高血压肾气亏虚证患者T水平及T/E₂比值均显著升高;女性老年高血压肾气亏虚证患者E₂水平升高,T/E₂比值降低。结论:益肾降压颗粒治疗老年高血压病肾气亏虚证疗效确定,不仅有良好的降压作用,还能改善患者临床症状,提高患者生存质量,并能纠正患者的性激素水平紊乱。更多还原

【Abstract】 Objective: To evaluate the curative effect of YSAG treating kidney qi deficiency syndrome of elderly hypertension and the changes in sex hormones of kidney qi deficiency syndrome of elderly hypertension and the impact of sex hormones.Methods:①In clinical research, 72 patients of elderly hypertension were divided into tentative group and control group at random. Each group has 36 cases. The tentative group was treated by YSAG, and the control group was treated by compound reserpine tablets. 28 days was a course of treatment. Before treatment, 7 day after treatment, 14 day after treatment, 28 day after treatment, casual blood pressure （CBP） were measured. Before and after treatment, ambulatory blood pressure monitoring （ABP）, blood lipids, blood glucose, EKG, integral of symptoms of Traditional Chinese Medicine （TCM）, integral of syndrome of TCM, integral of quality of life assessment were measured to value the curative effect of YSAG treating kidney qi deficiency syndrome of elderly hypertension.②30 cases healthy aged persons （15 males and 15 females） were selected as the normal control group, sex hormones （E₂, T, FSH, LH, T/E₂） were measured. From the tentative group, 15 males and 15 females of kidney qi deficiency syndrome of elderly hypertension were selected as control group, sex hormones （E₂, T, FSH, LH, T/E₂） were also measured before arid after treatment. So the impact of sex hormones was observed.Results:①YSAG has obvious effect on lowing the blood pressure, against myocardial ischemia, improving glucose and lipid metabolism, improving the patients clinical symptoms, decreasing the clinical symptom score and improving the quality of life.②The level of T and T/E₂ of kidney qi deficiency syndrome of male elderly hypertension was lower than healthy aged persons. The level of E₂ of kidney qi deficiency syndrome of female elderly hypertension was lower than healthy aged persons, the level of T/E₂ was higher than healthy aged persons. After treatment, the level of T and T/E₂ of kidney qi deficiency syndrome of male elderly hypertension was improved, the level of E₂ of kidney qi deficiency syndrome of female elderly hypertension was improved, the level of T/E₂ was lower.Conclusion: The YSAG is a group of effective drugs treating kidney qi deficiency syndrome of elderly hypertension. Besides of lowing the blood pressure, improving the clinical symptoms and quality of life, improving disturbance of sex hormone.更多还原