2025 年第 1 期 第 20 卷

加味黄连温胆汤治疗肥胖相关性高血压的临床效果及对同型半胱氨酸水平的影响

Clinical effect of modified Huanglian Wendan decoction in the treatment of obesity-related hypertension and its effect on homocysteine level

作者：韩艺1 韩宇博2 邹国良2 隋艳波2 董新禹1 刘莉2

英文作者：Han Yi1 Han Yubo2 Zou Guoliang2 Sui Yanbo2 Dong Xinyu1 Liu Li2

单位：1黑龙江中医药大学，哈尔滨150040；2黑龙江中医药大学附属第一医院心血管病一科，哈尔滨150040

英文单位：1Heilongjiang University of Chinese Medicine Harbin 150040 China; 2First Department of Cardiovascular Disease First Affiliated Hospital Heilongjiang University of Chinese Medicine Harbin 150040 China

关键词：高血压；  肥胖；  黄连温胆汤

英文关键词：Hypertension;  Obesity;  HuanglianWendandecoction

• 摘要：

• 目的  观察加味黄连温胆汤治疗肥胖相关性高血压患者的临床效果及对同型半胱氨酸水平的影响。方法  选取2023年3月至2024年3月就诊于黑龙江中医药大学附属第一医院的68例肥胖相关性高血压患者作为研究对象，按照随机数字表法分为对照组和观察组，每组34例。对照组给予常规西药治疗，观察组在对照组基础上给予加味黄连温胆汤治疗。2组均治疗8周。比较2组患者的中医证候疗效、治疗前后的血压、形体学指标、血脂和同型半胱氨酸水平、不良反应发生情况。结果  观察组治疗总有效率高于对照组［85.3%（29/34）比58.8%（20/34）］，差异有统计学意义（χ2=5.916，P=0.015）。治疗后，2组患者收缩压、舒张压、体重指数、腹围均低于治疗前，且观察组上述指标均低于对照组(均P＜0.05)。治疗后，2组患者甘油三酯、总胆固醇、低密度脂蛋白胆固醇、同型半胱氨酸水平均低于治疗前，高密度脂蛋白胆固醇水平高于治疗前，且观察组低密度脂蛋白胆固醇和同型半胱氨酸水平均低于对照组、高密度脂蛋白胆固醇水平高于对照组(均P＜0.05)。2组患者治疗过程中均未发生明显不良反应。结论  加味黄连温胆汤通过调节同型半胱氨酸水平提高对肥胖相关性高血压患者的治疗效果。

• Objective  To observe the clinical effect of modified Huanglian Wendan decoction in the treatment of obesity-related hypertension and its effect on homocysteine level. Methods   A total of 68 patients with obesity-related hypertension treated in First Affiliated Hospital, Heilongjiang University of Chinese Medicine from March 2023 to March 2024 were selected as research objects. According to the random number table method, they were divided into the control group and the observation group, with 34 cases in each group. The control group was treated with conventional western medicine, and the observation group was treated with modified Huanglian Wendan decoction on the basis of the control group. Both groups were treated for 8 weeks. The Traditional Chinese Medicine syndrome curative effect, blood pressure, physique index, blood lipid and homocysteine level before and after treatment, and adverse reactions were compared between the two groups. Results   The total effective rate of the observation group was higher than that of the control group ［85.3%(29/34) vs 58.8%(20/34)］(χ2=5.916, P=0.015). After treatment, the systolic blood pressure, diastolic blood pressure, body mass index and abdominal circumference of the two groups were lower than those before treatment, and the above indexes of the observation group were lower than those of the control group (all P＜0.05). After treatment, the levels of triglyceride, total cholesterol, low-density lipoprotein cholesterol and homocysteine in the two groups were lower than those before treatment, and the high-density lipoprotein cholesterol was higher than that before treatment. The levels of low-density lipoprotein cholesterol and homocysteine in the observation group were lower than those in the control group, and the level of high-density lipoprotein cholesterol in the observation group was higher than that in the control group (all P＜0.05). There were no obvious adverse reactions in the two groups during treatment. Conclusion   Modified Huanglian Wendan decoction can improve the therapeutic effect of obesity-related hypertension by regulating the level of homocysteine.