【作者】 鲍霞；

【导师】 丁书文；

【作者基本信息】 山东中医药大学 ， 中医内科学， 2004， 硕士

【摘要】 本论文提出了老年高血压从实证论治的论点，并从临床验证了黄连清降合剂对热毒血瘀证老年高血压患者的治疗效果。由于现代生存环境的变化和生活方式的改变，如环境污染、饮食肥甘、情志抑郁、缺乏锻炼、盲目进补等，老年人体质发生了很大变化，虚损之候逐渐减少，邪实表现日益突出，导致老年高血压患者实证日益增多。热毒内盛、瘀血阻络是其重要病机，清热解毒、活血化瘀是其重要治法。故创具有清热活血作用的黄连清降合剂治疗该病。临床验证将热毒血瘀证的1级、2级老年高血压患者随机分为两组，试验组予以黄连清降合剂治疗，对照组给予牛黄降压丸治疗，疗程1个月。结果治疗前后试验组偶测血压降低优于对照组， 24小时动态血压监测各项指标明显改善；对临床症状及舌脉的改善，试验组显著优于对照组；并且试验组疗后血脂系列、血流变指标、缺血性心电图改变皆明显改善，与对照组相比差异显著；内皮素(ET)、肿瘤坏死因子(TNF-α)、脂质过氧化物(LPO)亦明显降低(P<0． 05) 。黄连清降合剂不仅具有显著的降压疗效，而且明显改善临床症状及相关生化指标，验证了老年高血压从实证论治的正确性。本研究提出了老年高血压从实证论治的崭新思路，为老年高血压病的中医药治疗开辟了一条新的途径。更多还原

【Abstract】 This thesis bring forward the thought of treating elderly hypertensive disease (EH) by getting rid of excess syndrome, and observe the therapeutic effect of HuangLian QingJiang (HLQJ) Mixture in treating elderly hypertensive patients with evil heat and extravasated blood.Because the change of modern environment and life style, for example environmental pollution , fatting eat, contained feeling, lacking exercise, eating good food blindly, the physique of old people changes greatly. Weakness syndrome drops off, and excess syndrome increasingly stands out, which leads to more EH patients with excess syndrome. Excess of evil heat in the interior and extravasated blood in vessel are the mainly mechanism of this disease , and cleaning the heat and detoxifying and invigorating the circulation of blood are the important therapies to it. So we create HLQJ Mixture to treat it, which has the function of cleaning the heat and invigorating the circulation of blood.In clinic, 68 EH patients of 1 or 2 stage with evil heat and extravasated blood are randomly classified into two groups, in trail group patients are treated by HLQJ Mixture and in control group patients are treated by NiuHuang JiangYa pills, one-month was a course of treatment. After treatment the blood pressure of trail group drops more greatly than control group. Ambulatory blood pressure monitoring (ABPM) of trail group is improved obviously. The trail group is superior to control group in improving clinicalsymptom , the lipoprotein in the blood , the hemorheology, the myocardial ischemia. And. the levels of ET, TNF- α and LPO are reduced too. In one word , HLQJ Mixture can not only reduce blood pressure , but also improve clinical symptom and experimental targets. This validates the correctness of treating EH by getting rid of excess syndrome.This study bring forward the completely new thought of treating EH by getting rid of excess syndrome, open up a new way of TCM in EH treating.更多还原