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目的:探讨不同服药方法对于高血压治疗有效性和平稳性的影响。方法:采用随机、平行对照设计。对90例Ⅱ级及以上高血压患者,随机分为早晨服用硝苯地平控释片(拜新同)和缬沙坦(代文)组(甲组),早晨服缬沙坦晚上服硝苯地平控释片组(乙组),早晨服硝苯地平控释片晚上服缬沙坦组(丙组),患者均于服药前及服药后2周进行动态血压监测求得平滑指数等指标。结果:服药两周后,夜间、24h平均收缩压的下降值甲组小于乙、丙两组,P<0.01,夜间、24h平均动脉压的下降值甲组小于乙组,P<0.05,甲组小于丙组,P<0.01。甲组夜间、24h平均收缩压平滑指数小于乙、丙两组,P<0.01。夜间、24h平均动脉压平滑指数甲组小于乙组,P<0.05,甲组小于丙组,P<0.01,夜间舒张压平滑指数甲组小于乙组,P<0.01,甲组小于丙组,P<0.05。结论:联合用药降压效果显著,早晚分次服药较早晨顿服两种药能更有效控制夜间血压及使夜间及24h血压下降更平稳。
Objective: To investigate the effect of different medication methods on the effectiveness and stability of hypertension. Methods: Randomized, parallel control design. Ninety patients with grade II and higher hypertension were randomly divided into morning taking nifedipine controlled release tablets (thanks to the new) and valsartan (on behalf of the group) (group A), morning service valsartan evening nif (B group) and nifedipine controlled-release group (C group) in the evening. The patients were monitored with ambulatory blood pressure before taking the medication and 2 weeks after taking the medication to obtain the index of smoothness. Results: After two weeks of taking medicine, the average value of systolic blood pressure at night and 24h was lower than that of group B and B (P <0.01). The decrease of mean arterial pressure at night and 24h was less than that of group B (P <0.05) Less than group C, P <0.01. Group A at night, 24h average systolic pressure smoothing index is less than B, C two groups, P <0.01. At night, mean arterial pressure at 24h was lower in group A than in group B (P <0.05), group A was less than group C (P <0.01), nighttime diastolic pressure was lower in group A than group B, P <0.01, group A was smaller than group C <0.05. Conclusion: The antihypertensive effect of combination therapy is remarkable. Taking morning and evening doses of morning and evening morning serving two drugs can effectively control nocturnal blood pressure and make blood pressure drop more stable at night and 24 hours.