摘要
目的探讨高血压患者的服药方法,提高高血压控制率。方法在预临床观察基础上设置对照组、治疗组。对照组早上起床空腹一次性服用血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体拮抗剂(ACEI/ARB)、钙拮抗剂(CCB)或噻嗪类利尿剂。治疗组:Ⅰ期高血压只需服一种降压药,如噻嗪类利尿剂、ACEI/ARB或CCB药物,早餐后1 h内服;Ⅱ期高血压需联合应用ACEI/ARB和CCB药物,ACEI/ARB于早餐后1 h内服用,CCB于14:00-15:00服用,Ⅲ期高血压患者需多种药物联合应用,将ACEI/ARB和噻嗪类利尿剂于早餐后1 h内服,CCB于14:00-15:00服用。两组均按规定时间记录血压测量值,对两组不同服药时间、不同服药方法所得血压数据进行统计、分析。结果对照组患者24 h内血压波动明显,其中12例08:01-12:00出现休克样血压及临床表现,下午血压回升,次日呈现清晨高血压。治疗组患者24 h内血压平稳控制,无清晨高血压发生。清晨(06:30-08:00)对照组血压[收缩压(154.37±15.10)mm Hg,舒张压(91.64±7.20)mm Hg]与治疗组血压[收缩压(128.70±13.00)mm Hg,舒张压(75.00±8.10)mm Hg]比较,差异有统计学意义(P<0.01)。结论运用时间药理学优化服药方案,管理好清晨高血压,可显著提高高血压患者的血压控制率,使高血压的诊疗率等于控制率。
Objective To explore the methods of taking medication in patients with hypertension and improve the hypertension control rate.Methods A control group and a treatment group were set up on the basis of pre-clinical observations.Patients in the control group took angiotensin converting enzyme inhibitor/angiotensinⅡreceptor antagonist(ACEI/ARB),calcium antagonist(CCB)or thiazide diuretics at one time in the morning on an empty stomach condition.While in the treatment group,only one kind of antihypertensive drug was took orally at 1 hour after breakfast in patients with stageⅠhypertension.ACEI/ARB and CCB drugs were combined to use in patients with stageⅡhypertension,ACEI/ARB was taken within 1 hour after breakfast,and CCB was taken at 14:00-15:00 in the afternoon.Multiple drugs were combined to use in patients with stageⅢhypertension,ACEI/ARB and thiazide diuretics were taken within 1 hour after breakfast,and CCB was taken at 14:00-15:00 in the afternoon.The blood pressure measurement values of the two groups were recorded at the specified time,and the blood pressure data of the two groups were counted and analyzed.Results In the control group,blood pressure fluctuated significantly within 24 hours.Among them,12 patients had shock-like blood pressure and clinical manifestations from 08:01 to 12:00,blood pressure rose in the afternoon,and early morning hypertension occurred in the next day.The blood pressure of the patients in the treatment group was controlled steadily within 24 hours,and no early morning hypertension occurred.Early morning blood pressure(06:30-08:00)in the control group was:systolic blood pressure(154.37±15.10)mm Hg,diastolic blood pressure(91.64±7.20)mm Hg,the treatment group was:systolic blood pressure(128.70±13.00)mm Hg,diastolic blood pressure(75.00±8.10)mm Hg,the differences between the two groups were statistically significant(P<0.01).Conclusion Using time pharmacology to optimize the medication regimen to manage early morning hypertension can significantly improve the blood pressure control rate of hypertensive patients,and make the diagnosis and treatment rate of hypertension equal to the control rate.
作者
李琦晖
夏玲
刘东
李增高
LI Qihui;XIA Ling;LIU Dong;LI Zenggao(Department of Nephrology,Chongqing Hospital of Traditional Chinese Medicine (Daomenkou Branch),Chongqing 400011,China;Department of Cardiology,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)
出处
《重庆医学》
CAS
2021年第20期3514-3517,共4页
Chongqing medicine
基金
科研院所绩效激励引导专项(cstc2017jxjl130042)。
关键词
高血压
清晨
控制率
服药方案
hypertension
morning
control rate
method of taking medication
