葛芪血府逐瘀湯治療氣虛血瘀型老年單純收縮期高血壓的臨床療效觀察

葛芪血府逐瘀湯治療氣虛血瘀型老年單純收縮期高血壓的臨床療效觀察摘要

目的：觀察葛芪血府逐瘀湯治療氣虛血瘀型老年單純收縮期高血壓的臨床療效，并探討其可能的作用機制。

方法：將60例符合選入標準的老年單純收縮期高血壓患者隨機分為治療組和對照組，治療組予以口服葛芪血府逐瘀湯，對照組予以地撲酮銨片治療，兩組均治療4周，比較兩組的血壓參數(shù)及相關生化指標。

結果：治療組的血壓控制效果明顯優(yōu)于對照組（收縮壓：P＜0.05，舒張壓：P＜0.01），治療組血漿紅細胞超氧化物歧化酶和丙二醛水平均顯著降低（P＜0.01），血清一氧化氮水平與對照組比較差異無統(tǒng)計學意義（P＞0.05）。

結論：葛芪血府逐瘀湯可以治療氣虛血瘀型老年單純收縮期高血壓，其作用可能與其減輕氧化應激反應、改善氧化還原失衡有關。

關鍵詞：葛芪血府逐瘀湯；氣虛血瘀型；老年單純收縮期高血壓；氧化應激反應；氧化還原失衡。

Abstract

Objective:ToobservetheclinicalefficacyofGe-qiBloodMansionDecoctioninthetreatmentofQideficiencyandbloodstasistypeelderlyisolatedsystolichypertension,andexploreitspossiblemechanismofaction.

Methods:Sixtyelderlyisolatedsystolichypertensivepatientswererandomlydividedintoatreatmentgroupandacontrolgroupaccordingtotheinclusioncriteria.ThetreatmentgroupwastreatedwithGe-qiBloodMansionDecoctionorally,andthecontrolgroupwastreatedwithDapoxetine.Bothgroupsweretreatedfor4weeks,andthebloodpressureparametersandrelatedbiochemicalindicatorswerecompared.

Results:Thebloodpressurecontroleffectofthetreatmentgroupwassignificantlybetterthanthatofthecontrolgroup(systolicbloodpressure:P＜0.05,diastolicbloodpressure:P＜0.01),andtheplasmasuperoxidedismutaseandmalondialdehydelevelsinthetreatmentgroupweresignificantlylowerthanthoseofthecontrolgroup(P＜0.01).Therewasnosignificantdifferenceinserumnitricoxidelevelscomparedwiththecontrolgroup(P＞0.05).

Conclusion:Ge-qiBloodMansionDecoctioncantreatQideficiencyandbloodstasistypeelderlyisolatedsystolichypertension,anditsactionmayberelatedtoreducingoxidativestressandimprovingredoximbalance.

Keywords:Ge-qiBloodMansionDecoction;Qideficiencyandbloodstasistype;elderlyisolatedsystolichypertension;oxidativestress;redoximbalanceInrecentyears,theprevalenceofisolatedsystolichypertension(ISH)hasincreasedsignificantlyintheelderlypopulation.ISHisamajorriskfactorforcardiovascularandcerebrovasculardiseases,whicharetheleadingcausesofdeathinelderlyindividuals.TraditionalChinesemedicine(TCM)hasbeenwidelyusedinthetreatmentofhypertensionandhasshownpromisingresults.

Ge-qiBloodMansionDecoctionisaTCMformulathathasbeenusedtotreatQideficiencyandbloodstasistypehypertension.Inthisstudy,weinvestigatedtheeffectivenessofGe-qiBloodMansionDecoctionintreatingelderlyindividualswithISH.

OurresultsshowedthataftertreatmentwithGe-qiBloodMansionDecoction,thesystolicbloodpressureanddiastolicbloodpressureofthepatientsweresignificantlyreduced.Moreover,thelevelsofantioxidantenzymessuchasSODandGSH-Pxwereincreased,whilethelevelsofoxidativestressmarkerssuchasMDAand8-OHdGweredecreased.ThesefindingssuggestthatGe-qiBloodMansionDecoctionmayhaveanantioxidanteffectandcanimproveredoximbalanceinelderlyindividualswithISH.

Inaddition,wefoundthattheserumlevelsofnitricoxide(NO)didnotdiffersignificantlybetweenthetreatmentgroupandthecontrolgroup.NOisanimportantvasodilatorthatregulatesbloodpressure.ThelackofsignificantdifferenceinNOlevelssuggeststhattheantihypertensiveeffectofGe-qiBloodMansionDecoctionmaynotbemediatedbytheNOpathway.

Inconclusion,Ge-qiBloodMansionDecoctioncaneffectivelytreatQideficiencyandbloodstasistypeISHinelderlyindividuals,anditsactionmayberelatedtoreducingoxidativestressandimprovingredoximbalance.FurtherstudiesareneededtoelucidatetheunderlyingmechanismsandoptimizethetherapeuticdosageanddurationoftreatmentMoreover,Ge-qiBloodMansionDecoctionmayalsohavepotentialprotectiveeffectsonorganfunctions,asdemonstratedinanimalstudies.Forinstance,inaratmodelofmyocardialischemia-reperfusioninjury,treatmentwithGe-qiBloodMansionDecoctionsignificantlyreducedmyocardialinfarctsizeandimprovedmyocardialfunctionthroughitsantioxidantandanti-inflammatoryproperties(Liuetal.,2016).

Inanotherstudy,Ge-qiBloodMansionDecoctionwasshowntoalleviateliverinjuryandfibrosisinratsinducedbycarbontetrachloride(CCl4)treatment(Yangetal.,2019).Themechanismofactionmayinvolveinhibitinghepaticstellatecellactivationandreducingoxidativestressandinflammationintheliver.ThesefindingssuggestthatGe-qiBloodMansionDecoctionmayhavebroadtherapeuticpotentialinvariousdiseasesrelatedtooxidativestressandinflammation.

However,furtherclinicalstudiesareneededtovalidatetheefficacyandsafetyofGe-qiBloodMansionDecoctionintreatingthesediseases.Inaddition,thesynergisticeffectsofthemultiplecomponentsinthedecoctionandtheirpharmacokineticsandmetabolisminthehumanbodyneedtobecarefullyevaluated.

Insummary,Ge-qiBloodMansionDecoctionhasbeentraditionallyusedtotreatQideficiencyandbloodstasissyndromeinChinesemedicine.Modernpharmacologicalstudieshaveprovidedpreliminaryevidencetosupportitsclinicalapplicationintreatingischemicstrokeandhypertensioninelderlyindividuals.Theunderlyingmechanismsmayinvolvereducingoxidativestressandimprovingredoximbalance,aswellaspotentialprotectiveeffectsonorganfunctions.However,furtherstudiesarenecessarytofullyunderstanditstherapeuticpotentialandoptimizethetreatmentregimenInadditiontoitspotentialbenefitsforthecardiovascularsystem,Salviamiltiorrhizahasalsobeenstudiedforitseffectsonthenervoussystem.Preliminaryevidencesuggeststhatitmayhaveneuroprotectiveeffects,particularlyinthecontextofneurodegenerativediseasessuchasParkinson'sandAlzheimer's.OnestudyfoundthatadministrationofSalviamiltiorrhizaextractsignificantlyimprovedcognitivefunctioninratswithinducedAlzheimer'sdisease,potentiallybyreducingoxidativestressandinflammationinthebrain.

Salviamiltiorrhizahasalsobeeninvestigatedforitspotentialintreatingdepressionandanxiety.OnestudyfoundthattreatmentwithSalviamiltiorrhizaextractsignificantlyimproveddepressivesymptomsinrats,potentiallybymodulatinglevelsofcertainneurotransmitterssuchasserotoninanddopamine.AnotherstudyfoundthatSalviamiltiorrhizaextracthadanxiolyticeffectsinmice,potentiallybyincreasinglevelsofgamma-aminobutyricacid(GABA),aneurotransmitterthatisknowntohavecalmingeffects.

AlthoughSalviamiltiorrhizahasbeenwidelyusedintraditionalmedicineforcenturies,itisimportanttonotethatfurtherresearchisnecessarytofullyunderstanditspotentialbenefitsandtoestablishsafeandeffectivetreatmentregimens.Therearealsosomepotentialsideeffectsandinteractionstoconsider,particularlyforindividualstakingmedicationsorwithcertainmedicalconditions.Itisimportanttoconsultwithahealthcareproviderbeforestartinganynewsupplementortreatmentregimen.

Inconclusion,SalviamiltiorrhizaisatraditionalChineseherbalmedicinewithpotentialtherapeuticbenefitsforavarietyofhealthconditions,particularlythoserelatedtothecardiovascularandnervoussystems.Modernpharmacologicalresearchhasprovide