涤痰降压方加减治疗痰热上扰型原发性高血压患者的回顾性分析

Retrospective Analysis of Modified Ditan Jiangya Decoction in the Treatment of Essential Hypertension with Phlegm-Heat Disturbing the Upper Orifices Pattern

摘要: 目的：探讨涤痰降压方联合常规降压药治疗痰热上扰型原发性高血压的临床疗效，为中西医结合治疗该类型高血压提供循证依据。方法：回顾性收集2020年2月至2024年8月就诊于黑龙江中医药大学附属第二医院心血管一科的132例痰热上扰型原发性高血压患者，按治疗方案分为治疗组(65例，常规降压药 + 涤痰降压方)与对照组(67例，单纯常规降压药)。治疗4周后，比较两组中医证候积分、诊室血压、24 h动态血压及临床疗效。结果：治疗后，两组患者中医证候总积分均显著下降(P < 0.05)，且治疗组(5.80 ± 4.848)低于对照组(14.81 ± 8.628)，治疗组中医证候总有效率(89.23%)高于对照组(59.70%) (P < 0.05)；两组诊室收缩压、舒张压均明显降低(P < 0.05)，治疗组降压总有效率(86.67%)高于对照组(68.66%) (P < 0.05)；治疗组24 h动态平均血压、日间及夜间平均血压、动态脉压、血压负荷、血压变异系数等指标改善幅度均优于对照组(P < 0.05)。结论：涤痰降压方联合常规降压药治疗痰热上扰型原发性高血压，能更显著降低患者血压水平，改善中医证候及动态血压相关指标，临床疗效确切。

Abstract: Objective: To explore the clinical efficacy of Ditan Jiangya Decoction combined with conventional antihypertensive drugs in the treatment of essential hypertension with phlegm-heat disturbing the upper orifices pattern, and to provide evidence-based basis for integrated traditional Chinese and Western medicine in the treatment of this type of hypertension. Methods: A retrospective collection was conducted on 132 patients with essential hypertension of phlegm-heat disturbing the upper orifices pattern who were admitted to the First Department of Cardiovascular Medicine, the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine from February 2020 to August 2024. They were divided into the treatment group (65 cases, conventional antihypertensive drugs + Ditan Jiangya Decoction) and the control group (67 cases, conventional antihypertensive drugs alone) according to the treatment plan. After 4 weeks of treatment, the TCM syndrome scores, office blood pressure, 24-hour ambulatory blood pressure and clinical efficacy were compared between the two groups. Results: After treatment, the total TCM syndrome scores of both groups decreased significantly (P < 0.05), and the treatment group (5.80 ± 4.848) was lower than the control group (14.81 ± 8.628). The total effective rate of TCM syndrome in the treatment group (89.23%) was higher than that in the control group (59.70%) (P < 0.05). The office systolic blood pressure and diastolic blood pressure in both groups were significantly reduced (P < 0.05), and the total antihypertensive effective rate in the treatment group (86.67%) was higher than that in the control group (68.66%) (P < 0.05). The improvement of 24-hour ambulatory mean blood pressure, daytime and nighttime mean blood pressure, ambulatory pulse pressure, blood pressure load, blood pressure variability coefficient and other indicators in the treatment group was superior to that in the control group (P < 0.05). Conclusion: Ditan Jiangya Decoction combined with conventional antihypertensive drugs in the treatment of essential hypertension with phlegm-heat disturbing the upper orifices pattern can more significantly reduce the patient’s blood pressure level, improve TCM syndromes and ambulatory blood pressure-related indicators, with definite clinical efficacy.