【摘要】：目的:觀察加味二至丸對(duì)絕經(jīng)后女性高血壓患者雌激素、血脂、內(nèi)皮功能的影響。方法:本研究為前瞻性研究,采用隨機(jī)對(duì)照的方法,篩選廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院心血管內(nèi)科2014年7月-2015年3月住院部及門(mén)診自然絕經(jīng)的高血壓病患者60例。將上述60例患者按隨機(jī)數(shù)字表法分為對(duì)照組和治療組,其中對(duì)照組30例,治療組30例。對(duì)照組:高血壓病1級(jí)患者不予西藥治療,高血壓病2級(jí)患者予苯磺酸氨氯地平片和厄貝沙坦片聯(lián)合治療。治療組:在與對(duì)照組相同西醫(yī)治療方案基礎(chǔ)上加用加味二至丸顆粒。兩組患者分別于治療0周和治療4周時(shí)取禁食10小時(shí)后外周靜脈血3ml離心后備用,電化學(xué)發(fā)光法測(cè)定雌二醇(Estradiol,E2)、雙抗體夾心法測(cè)定血清一氧化氮(Nitric oXide,N0)及內(nèi)皮素-1(Endothelin-1,ET-1)水平,速率法測(cè)定肝功能,酶法測(cè)定腎功能,膽固醇氧化酶(C0D-PAP)法測(cè)總膽固醇(Total cholesterol,TC),甘油磷酸氧化酶—過(guò)氧化物酶(GP0-PAP)法測(cè)定甘油三酯(Triglyceride,TG),采用阻抗、激光散射和熒光染色技術(shù)檢測(cè)法測(cè)定白細(xì)胞(White blood cells,WBC)、紅細(xì)胞(Red blood cell,RBC)、血紅蛋白(Hemoglobin,HGB)、血小板(Platelet,PLT)。兩組患者分別于治療0周和治療4周時(shí)填寫(xiě)改良Kupperman表格。所有實(shí)驗(yàn)數(shù)據(jù)采用SPSS19.0軟件處理,計(jì)量資料采用均數(shù)士標(biāo)準(zhǔn)差表示,計(jì)量資料組內(nèi)比較采用配對(duì)t檢驗(yàn),計(jì)量資料組間比較采用方差分析,計(jì)數(shù)資料構(gòu)成比、率的組間及治療前后比較用χ2檢驗(yàn),等級(jí)資料用秩和檢驗(yàn),p0.05表示差異有統(tǒng)計(jì)學(xué)意義,p0.01表示有顯著統(tǒng)計(jì)學(xué)意義。結(jié)果:1.干預(yù)0周時(shí),兩組患者治療前的年齡、絕經(jīng)時(shí)間、高血壓病程、E2、TG、TC、N0、ET-1、Scr、ALT、AST及血液分析水平比較差異無(wú)統(tǒng)計(jì)學(xué)意義(p0.05),兩組患者間具有可比性,治療過(guò)程中,治療組無(wú)病例脫落。2.性激素缺乏癥狀:干預(yù)4周后,與對(duì)照組比較,治療組患者治療改良Kupperman總分的下降及療效指數(shù)的升高有顯著統(tǒng)計(jì)學(xué)差異(P0.05)。3.雌二醇:干預(yù)4周后,與對(duì)照組比較,治療組的雌激素水平無(wú)顯著統(tǒng)計(jì)學(xué)差異(p0.05)。4.血脂:干預(yù)4周后,與對(duì)照組比較,治療組的TC、TG水平下降程度有統(tǒng)計(jì)學(xué)意義(p0.05)。5.內(nèi)皮功能指標(biāo):干預(yù)4周后,與對(duì)照組比較,治療組的N0水平上升程度及ET-1水平下降程度有統(tǒng)計(jì)學(xué)意義(P0.05)。6.安全性評(píng)估:干預(yù)4周后,與對(duì)照組比較,治療組的肝腎功能指標(biāo)無(wú)顯著統(tǒng)計(jì)學(xué)差異(P0.05)。.結(jié)論:加味二至丸有改善患者雌激素缺乏癥狀,降低TC、TG、ET-1水平及升高N0水平的作用,對(duì)絕經(jīng)后女性高血壓患者的E2水平無(wú)明顯影響,推測(cè)加味二至丸可能通過(guò)擬雌激素樣作用改善絕經(jīng)后女性高血壓患者的雌激素缺乏癥狀、血管內(nèi)皮功能及降低TC、TG,對(duì)絕經(jīng)后女性高血壓患者的肝腎功能無(wú)急性損害。
[Abstract]:Aim: to observe the effects of Jiawei Erzhi pill on estrogen, blood lipid and endothelial function in postmenopausal women with hypertension. Methods: this study was a prospective study. A randomized controlled study was used to screen 60 patients with hypertension in the Department of Cardiovascular Medicine of the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine from July 2014 to March 2015. The above 60 patients were randomly divided into control group and treatment group, including 30 cases in control group and 30 cases in treatment group. Control group: patients with hypertension grade 1 were not treated with western medicine, patients with hypertension grade 2 were treated with amlodipine benzenesulfonic acid and irbesartan tablets. Treatment group: in the control group on the basis of the same Western medicine treatment program plus Jiawei Erzhi Pill granule. After fasting for 10 hours, peripheral venous blood 3ml was centrifuged and estradiol (Estradiol,E2) was measured by electrochemiluminescence and serum nitric oxide (Nitric oXide, was determined by double antibody sandwich method. The levels of N0) and endothelin-1 (Endothelin-1,ET-1), liver function, renal function, cholesterol oxidase (C0D-PAP) and total cholesterol (Total cholesterol,TC) were measured by rate method, renal function and cholesterol oxidase (C0D-PAP) method, respectively. Glycerophosphate oxidase peroxidase (GP0-PAP) method was used to determine triglyceride (Triglyceride,TG), leucocyte (White blood cells,WBC and erythrocyte (Red blood cell,RBC were detected by impedance, laser scattering and fluorescence staining. Hemoglobin (Hemoglobin,HGB), platelet (Platelet,PLT). The modified Kupperman form was completed at 0 weeks and 4 weeks after treatment in both groups. All the experimental data were processed by SPSS19.0 software, the measurement data were represented by the standard deviation of the mean value, the comparison in the measurement data group was matched t test, the analysis of variance was used in the comparison between the measurement data groups, and the composition ratio of the counting data was calculated. 蠂 2 test and rank sum test were used in the comparison of the rates between groups and before and after treatment. The difference was statistically significant between p0.05 and p0.01, respectively. Results: 1. At 0 weeks after intervention, there was no significant difference in age, menopausal time, course of hypertension, E2TGG TC0 / ET-1 and blood analysis between the two groups (p0.05). Two groups of patients are comparable, treatment process, treatment group, no cases fall off. 2. Sex hormone deficiency symptoms: after 4 weeks of intervention, compared with the control group, the total score of modified Kupperman and the increase of curative effect index in the treatment group were significantly lower than those in the control group (P0.05). Estradiol: after 4 weeks of intervention, there was no significant difference in estrogen level between the treatment group and the control group (p0.05). Blood lipids: after 4 weeks of intervention, compared with the control group, the level of TC,TG in the treatment group decreased significantly (p0.05). Endothelial function index: after 4 weeks of intervention, compared with the control group, the level of N0 increased and the level of ET-1 decreased significantly in the treatment group (P0.05). Safety assessment: after 4 weeks of intervention, there was no significant difference in liver and kidney function between the treatment group and the control group (P0.05). Conclusion: Jiawei Erzhi pills can improve the symptoms of estrogen deficiency, decrease the level of TC,TG,ET-1 and increase the level of N0, but have no effect on the level of E2 in postmenopausal women with hypertension. It is speculated that Jiawei Erzhi pills can improve the symptoms of estrogen deficiency in postmenopausal women with hypertension, and decrease the function of vascular endothelium and decrease of TC,TG, on the liver and kidney function of postmenopausal women with hypertension.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R544.1

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