王威 范倩 王帅 马迪 张秀静

摘要 目的：探討柴胡加龙骨牡蛎汤加减联合平衡针灸对原发性高血压患者血压水平、脂糖代谢及睡眠质量的影响。方法：选取2018年1月至2019年6月北京中医药大学第三附属医院收治的原发性高血压患者78例作为研究对象，按照随机数字表法分为对照组和观察组，每组39例，对照组采用常规西医治疗，观察组采用柴胡加龙骨牡蛎汤加减联合平衡针灸治疗，比较2组患者临床疗效、血压水平、中医证候积分、脂糖代谢、睡眠质量及不良反应。结果：治疗8周后，观察组的临床总有效率为89.74%（35/39），显著高于对照组的66.67%（26/39）（P<0.05）。2组患者治疗8周后收缩压（SBP）、舒张压（DBP）均下降，且观察组低于对照组（P<0.05）。2组患者治疗8周后睡眠障碍、睡眠时间、睡眠质量、睡眠效率、日间功能障碍、入睡时间、催眠药物等睡眠质量评分以及急躁易怒、眩晕、头痛、腰膝酸软、失眠健忘及耳鸣等中医症状评分均降低，且观察组低于对照组（P<0.05）。2组患者治疗8周后空腹血糖、总胆固醇（TC）、低密度脂蛋白（LDL-C）、三酰甘油（TG）降低，高密度脂蛋白（HDL-C）升高（P<0.05）;观察组治疗8周后空腹血糖、TG、TC、LDL-C低于对照组，HDL-C则高于对照组（P<0.05）。2组不良反应发生率比较差异无统计学意义（P>0.05）。结论：原发性高血压患者给予柴胡加龙骨牡蛎汤加减联合平衡针灸治疗，可改善患者临床症状、脂糖代谢及睡眠质量，疗效确切，且不良反应较少，具有一定的临床应用价值。

关键词 柴胡加龙骨牡蛎汤;平衡针灸;原发性高血压;血压;脂糖代谢;睡眠质量

Effects of Radix Bupleur Plus Modified Longgu Muli Decoction Combined with Balanced

Acupuncture and Moxibustion onEssential Hypertension

WANG Wei，FAN Qian，WANG Shuai，MA Di，ZHANG Xiujing

（The Third Affiliated Hospital，Beijing University of Chinese Medicine，Beijing 100029，China）

Abstract Objective：To explore the effects of Radix Bupleur plus modified Longgu Muli Decoction Combined with balanced acupuncture and moxibustion on blood pressure level，lipid and glucose metabolism and sleep quality in patients with essential hypertension.Methods：A total of 78 patients with essential hypertension who were admitted to the Third Affiliated Hospital of Beijing University of Chinese Medicine from January 2018 to June 2019 were selected as the research objects.According to the random number table method，they were divided into a control group（n=39，routine Western medicine treatment）and an observation group（n=39，Radix Bupleur plus modified Longgu Muli Decoction combined with balanced acupuncture and moxibustion）.The clinical efficacy，blood pressure level，TCM syndrome score，lipid and glucose metabolism，sleep quality and adverse reactions were compared between the 2 groups.Results：The total effective rate of the study group was 89.74%（35/39）at 8 weeks after treatment，which was significantly higher than that of the control group 66.67%（26/39）（P<0.05）.The systolic blood pressure（SBP）and diastolic blood pressure（DBP）of the 2 groups decreased at 8 weeks after treatment，and those of the study group were lower than those of the control group（P<0.05）.8 weeks after treatment，the scores of sleep disorders，sleep time，sleep quality，sleep efficiency，daytime dysfunction，sleep time，hypnotics drugs and other sleep quality score，as well as the scores of irritability，vertigo，headache，waist and knee tenderness，insomnia，forgetfulness，tinnitus and other TCM symptoms decreased，and those of the observation group were lower than those of the control group（P<0.05）.8 weeks after treatment，the fasting blood glucose，total cholesterol（TC），low density lipoprotein cholesterol（LDL-C），triglycerides（TG）decreased and high density lipoprotein cholesterol（HDL-C）increased in both groups（P<0.05）.The fasting blood glucose，TG，TC and LDL-C in the observation group were lower than those in the control group，while HDL-C was higher than that in the control group（P<0.05）.There was no significant difference in the incidence of adverse reactions between the 2 groups（P>0.05）.Conclusion：Radix Bupleur plus modified Longgu Muli Decoction combined with balanced acupuncture and moxibustion can improve the clinical symptoms，lipid and glucose metabolism and sleep quality of patients with essential hypertension with definite curative effect，and it has less adverse reactions，which has certain clinical application value.

Keywords Radix Bupleur plus Longgu Muli Decoction; Balanced acupuncture and moxibustion; Essential hypertension; Blood pressure; Lipid and glucose metabolism; Sleep quality

中图分类号：R255.3;R255.2;R246.1文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.02.020

原发性高血压是指原因不明的高血压，具有发病率高、需终身用药、并发症多等特点，是临床常见的心脑血管疾病[1-2]。若患者长期血压控制不良，可能引起肾功能下降、脑出血等靶器官损伤[3]。降压是临床治疗该病的关键，现临床常用的降压药物有钙离子拮抗剂、β受体阻滞剂、血管紧张素Ⅱ受体阻断剂、血管紧张素转换酶抑制剂及利尿剂等，虽可在一定程度上阻止病情进展，但停药后极易复发，病情迁延不愈，且西药长期治疗不良反应较大，患者依从性差[4-5]。……