王海礁 王志敏

[摘要] 目的 探讨糖尿病合并高血压药物治疗的合理应用分析及不良反应分析。方法 将2016年1月—2019年8月在该院全科治疗的120例糖尿病合并高血压患者随机分为两组，均给予常规降糖治疗，对照组使用厄贝沙坦治疗，观察组使用硝苯地平联合厄贝沙坦治疗，于治疗8周后对比两组的临床疗效、血压及血糖控制情况、不良反应。 结果 观察组治疗有效率为95.00%，明显高于对照组的76.67%（P<0.05）;观察组治疗后SBP、DBP、FBG、2 hPG、HbA1c、24 h尿微量蛋白水平均明显低于对照组（P<0.05）;观察组恶心呕吐、头痛、颜面潮红、乏力等不良反应发生率与对照组相比差异无统计学意义（P>0.05）。结论 糖尿病合并高血压使用硝苯地平联合厄贝沙坦治疗效果显著，能有效控制血压，提高对血糖的控制效果，并能保护肾功能，降低24 h尿微量蛋白水平，且不良反应发生率低，具有较高的疗效性及安全性。

[关键词] 糖尿病合并高血压;硝苯地平;厄贝沙坦;疗效;不良反应

[中图分类号] R587.1;R544.1          [文献标识码] A          [文章编号] 1672-4062（2020）07（b）-0056-03

[Abstract] Objective To explore the rational application analysis and adverse reaction analysis of diabetes combined with hypertension. Methods 120 patients with diabetes mellitus and hypertension who were treated in the hospital from January 2016 to August 2019 were randomly divided into two groups， all were given conventional hypoglycemic therapy， the control group was treated with irbesartan， and the observation group was used Nifedipine combined with irbesartan treatment， after 8 weeks of treatment， the clinical efficacy， blood pressure and blood glucose control， and adverse reactions of the two groups were compared. Results The treatment effective rate of the observation group was 95.00%， which was significantly higher than that of the control group 76.67% （P<0.05）; after treatment， the observation group SBP， DBP， FBG， 2 hPG， HbA1c， 24 h urine microprotein levels were significantly lower than the control group （P<0.05）; the incidence of adverse reactions such as nausea， vomiting， headache， facial flushing， and fatigue in the observation group was not statistically significantly different from that in the control group （P>0.05）. Conclusion Nifedipine combined with irbesartan is effective in the treatment of diabetes and hypertension. It can effectively control blood pressure， improve the control effect on blood glucose， protect renal function， reduce the 24-hour urine microprotein level， and has a low incidence of adverse reactions. It has high curative effect and safety.

[Key words] Diabetes with hypertension; Nifedipine; Irbesartan; Efficacy; Adverse reactions

糖尿病和高血压均是临床常见的慢性疾病，两病可相互影响，促进病情进展，导致病情更为复杂难治。临床研究显示，2型糖尿病患者发生高血压的几率明显升高，且糖尿病合并高血压患者的心、脑、肾等重要脏器加速恶化，大大提高了并发症发生率，也明显升高了病死率[1]。目前，臨床对糖尿病合并高血压的治疗也从单一用药过度到联合用药，如何合理应用药物，提升疗效，降低药物不良反应，是临床需要解决的问题。硝苯地平属于钙离子通道阻滞剂，通过阻滞钙离子内流，达到松弛血管平滑肌，降低外周动脉阻力，降低血压的目的[2]。厄贝沙坦属于血管紧张素酶抑制剂（ARB），能特异性拮抗AngⅡ1型受体（AT1），阻止AngⅡ与AT1结合，抑制血管收缩，降低血压[3]。……