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目的探讨缬沙坦氨氯地平合用治疗老年性原发性高血压合并2型糖尿病患者的临床疗效。方法选取2015年3月至2016年3月广州市番禺区南村镇社区卫生服务中心就诊的200例原发性高血压合并2型糖尿病患者作为研究对象,随机分为采用氨氯地平治疗的对照组和缬沙坦联合氨氯地平治疗的观察组,每组100例。治疗3个月后,比较两组患者收缩压、舒张压、心率、心输出率以及血糖、胰岛素水平。结果经过治疗后,两组患者的收缩压、舒张压均下降,且观察组患者收缩压和舒张压下降水平明显大于对照组(P<0.05)。两组患者的血糖水平(空腹血糖、餐后两小时血糖)均明显下降,对照组患者血糖下降程度明显低于观察组(P<0.05)。两组患者治疗前的空腹血清胰岛素及胰岛素敏感性指数变化相比较,差异无统计学意义(P>0.05);治疗后,心率、心输出率并无明显变化(P>0.05)。结论氨氯地平单药治疗与氨氯地平联合缬沙坦治疗均能有效控制糖尿病高血压,但缬沙坦联合氨氯地平降压效果更好,且能更为有效的控制血糖。
Objective To investigate the clinical efficacy of valsartan combined with amlodipine in the treatment of elderly patients with essential hypertension and type 2 diabetes mellitus. Methods From March 2015 to March 2016, 200 patients with essential hypertension and type 2 diabetes who were treated in Nancun Community Health Service Center, Panyu District, Guangzhou City were selected and randomly divided into control group treated with amlodipine And valsartan combined with amlodipine treatment group, 100 cases in each group. Three months after treatment, systolic blood pressure, diastolic blood pressure, heart rate, cardiac output, blood glucose and insulin levels were compared between the two groups. Results After treatment, systolic blood pressure and diastolic blood pressure decreased in both groups, and the systolic and diastolic blood pressure levels in the observation group were significantly higher than those in the control group (P <0.05). The blood glucose level (fasting blood glucose and postprandial blood glucose two hours) in both groups were significantly decreased, and the blood sugar level in the control group was significantly lower than that in the observation group (P <0.05). There was no significant difference in fasting serum insulin and insulin sensitivity index between the two groups before treatment (P> 0.05). There was no significant change in heart rate and cardiac output after treatment (P> 0.05). Conclusion Both amlodipine monotherapy and amlodipine combined with valsartan can effectively control diabetic hypertension. However, valsartan combined with amlodipine has a better antihypertensive effect and can control blood sugar more effectively.