Department of Neurology, First Affiliated Hospital of Sun Yatsen University, Guangzhou 510080, China.
Chin J Integr Med. 2012 Oct;18(10):746-51. doi: 10.1007/s11655-012-1231-7. Epub 2012 Sep 11.
To investigate the effects and safety of Western medicine combined with Chinese medicine (CM) based on syndrome differentiation in the treatment of elderly polarized hypertension (PHPT), or isolated systolic hypertension with low diastolic blood pressure (DBP).
A total of 125 elderly patients with PHPT were randomly assigned to two groups: 59 in the control group treated by Western medicine and 66 in the intervention group treated by Western medicine combined with CM treatment. Based on syndrome differentiation, the patients in the intervention group were further divided into subgroups of yang-qi deficiency and yin-qi deficiency. All subjects were treated with Western medicine of Amlodipine Besylate Tablets and Irbesartan Tablets (or Irbesartan and Hydrochlorothiazide Tablets), to decrease their systolic blood pressure (SBP) slowly to 125-135 mm Hg in 2-6 weeks. In the intervention group, Shiyiwei Shenqi Capsule was given additionally to the subgroup of yang-qi deficiency at the dosage of 3-5 capsules, thrice a day, while Dengzhan Shengmai Capsule was given additionally to the subgroup of yin-qi deficiency at the dosage of 2 capsules, 2-3 times per day. For all subjects, SBP, pulse pressure (PP), and DBP were measured before treatment and at the terminal of a 6-week treatment. For subjects in the intervention group, left ventricular ejection fraction (LVEF) was also recorded.
After a 6-week treatment, the SBP in the two groups and the PP in the intervention group decreased significantly compared to those before treatment (P<0.05), while the PP in the control group showed no significant difference between prior and post-treatment (P>0.05). After treatment, the DBP in the control group decreased (P>0.05), while the DBP and LVEF in the intervention group showed an increase tendency although it had no statistical significance (P>0.05). When subjects in the intervention group were classified further by the course of disease, the DBP and LVEF of subjects whose course of disease were less than 2 years, increased significantly after treatment (P<0.05).
Western medicine combined with CM treatment based on syndrome differentiation was safer and more effective than Western medicine alone in the treatment of elderly PHPT, because it not only reduced SBP but also improved DBP, which might lower the incidence of the cardiovascular and cerebrovascular events.
观察西药结合中医辨证治疗老年单纯收缩期高血压伴舒张压偏低（ISH-DBP）或两极型高血压（PHPT）的疗效及安全性。
将 125 例老年 PHPT 患者随机分为两组，对照组 59 例采用西药治疗，观察组 66 例在对照组基础上采用中医辨证治疗，根据证型分为气虚阳浮证和气阴两虚证，两组患者均采用苯磺酸氨氯地平片和厄贝沙坦片（或厄贝沙坦氢氯噻嗪片）治疗，使收缩压（SBP）在 26 周内缓慢降至 125135mmHg。气虚阳浮证观察组加用十一味参芪胶囊，每次 35 粒，每日 3 次；气阴两虚证观察组加用灯盏生脉胶囊，每次 2 粒，每日 23 次。观察两组患者治疗前后及治疗 6 周末的 SBP、脉压（PP）、舒张压（DBP）变化，气虚阳浮证观察组患者还记录左心室射血分数（LVEF）。
两组患者治疗 6 周末 SBP、观察组患者治疗 6 周末 PP 较治疗前均明显降低（P<0.05），对照组患者治疗前后 PP 差异无统计学意义（P>0.05）；对照组患者治疗后 DBP 较治疗前降低（P>0.05），观察组患者治疗后 DBP 及 LVEF 呈升高趋势，但差异均无统计学意义（P>0.05）。进一步按病程分组，病程<2 年的观察组患者治疗后 DBP、LVEF 较治疗前明显升高（P<0.05）。
西药结合中医辨证治疗老年 PHPT 较单纯西药治疗更安全有效，不仅能降低 SBP，还能改善 DBP，可能降低心脑血管事件的发生率。
