天麻钩藤饮加减联合针刺对阴虚阳亢型高血压患者血压波动及臂踝脉搏波传导速度的影响*

作者：刘华丹，刘汉顺，黄春华，邢齐树，吴 蓉

单位：合肥市第三人民医院，安徽 合肥 230022

引用：引用：刘华丹，刘汉顺，黄春华，邢齐树，吴蓉.天麻钩藤饮加减联合针刺对阴虚阳亢型高血压患者血压波动及臂踝脉搏波传导速度的影响[J].中医药导报,2025,31(4):114-117,126.

DOI：10.13862/j.cn43-1446/r.2025.04.018

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摘要：

目的：探究天麻钩藤饮加减联合针刺对阴虚阳亢型高血压患者血压波动及臂踝脉搏波传导速度（baPWV）的影响。方法：将合肥市第三人民医院中医科2023年1月到2024年1月收治的60例高血压患者，按照随机数字表法分为对照组和观察组，各30例。对照组采用常规西药控制血压，观察组在对照组治疗基础上，使用天麻钩藤饮加减联合针刺治疗。比较两组患者治疗前后血压水平[收缩压（SBP）、舒张压（DBP）]、baPWV、血压波动情况[24 h平均收缩压（MSBP）、24 h平均舒张压（DSBP）、24 h收缩压变异系数（SBPCV）、24 h舒张压变异系数（DBPCV）]、中医证候积分、血管内皮生长因子（VEGF）、同型半胱氨酸（Hcy）及临床疗效。结果：观察组总有效率为93.33%（28/30），对照组为73.33%（22/30），差异有统计学意义（P＜0.05）。治疗后，两组患者SBP、DBP、baPWV、24 h MSBP、24 h DSBP、24 h SBPCV、24 h DBPCV、中医证候积分、血清VEGF及Hcy水平均较治疗前降低，且观察组均低于对照组（P＜0.05）。结论：天麻钩藤饮加减联合针刺应用于阴虚阳亢型高血压患者，可有效降低血压及baPWV，改善血压波动情况，疗效确切，其作用机制可能与下调VEGF、Hcy水平相关。

关键词：高血压；阴虚阳亢；天麻钩藤饮；针刺；血压波动；臂踝脉搏波传导速度

Abstract：

Objective: To investigate the effects of modified Tianma Gouteng Decoction (天麻钩藤饮) combined with acupuncture on blood pressure variability and brachial-ankle pulse wave velocity (baPWV) in hypertensive patients with Yin deficiency and Yang hyperactivity. Methods: Sixty hypertensive patients admitted to the Department of Traditional Chinese Medicine at Hefei Third People's Hospital from January 2023 to January 2024 were randomly divided into a control group (30 cases) and an observation group (30 cases). The control group received conventional antihypertensive drugs, while the observation group was treated with modified Tianma Gouteng Decoction and acupuncture in addition to the control regimen. Blood pressure parameters [systolic blood pressure (SBP), diastolic blood pressure (DBP)], baPWV, blood pressure variability [24-hour mean SBP (MSBP), 24-hour mean DBP (MDBP), 24-hour SBP coefficient of variation (SBPCV), 24-hour DBP coefficient of variation (DBPCV)], traditional Chinese medicine (TCM) syndrome scores, vascular endothelial growth factor (VEGF), and homocysteine (Hcy) were compared before and after treatment. The clinical efficacy aslo was compared between the two groups. Results: The total effective rate was 93.33% (28/30) in the observation group and 73.33% (22/30) in the control group, with a statistically significant difference (P<0.05). After treatment, both groups showed reductions in SBP, DBP, baPWV, 24-hour MSBP, 24-hour MDBP, 24-hour SBPCV, 24-hour DBPCV, TCM syndrome scores, and serum levels of VEGF and Hcy. Moreover, the observation group exhibited significantly lower values than the control group in all parameters (P<0.05). Conclusion: Modified Tianma Gouteng Decoction combined with acupuncture effectively reduces blood pressure, baPWV, and blood pressure variability in hypertensive patients with Yin deficiency and Yang hyperactivity. The therapeutic mechanism may be associated with downregulation of VEGF and Hcy levels.

Key words：hypertension; Yin deficiency and Yang hyperactivity; Tianma Gouteng Decoction; acupuncture; blood pressure variability; brachial-ankle pulse wave velocity

发布时间：2025-12-20

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