清肝降火方联合西药治疗肝火亢盛型原发性高血压的临床观察

清肝降火方联合西药治疗肝火亢盛型原发性高血压的临床观察摘要：目的：探讨清肝降火方联合西药治疗肝火亢盛型原发性高血压的疗效和安全性。方法：随机选择120例肝火亢盛型原发性高血压患者，随机分为治疗组和对照组，每组60例。两组均给予西药治疗，治疗组在此基础上加用清肝降火方，对照组不用。疗程为3个月。比较两组治疗后的临床疗效、生命质量、肝功、心电图等指标，以及不良反应的发生情况和严重程度。结果：治疗组和对照组的总有效率分别为93.3%和80.0%（P<0.05），治疗组的临床症状、生命质量评分、肝功指标、心电图等均优于对照组（P<0.05）。治疗组和对照组不良反应发生率分别为13.3%和20.0%，治疗组不良反应轻微、可耐受。结论：清肝降火方联合西药治疗肝火亢盛型原发性高血压的疗效确切、安全性高，值得临床推广应用。

关键词：清肝降火方；西药；肝火亢盛型原发性高血压；临床观察

Abstract:Objective:ToexploretheefficacyandsafetyofQingganJianghuoFangcombinedwithwesternmedicineinthetreatmentofliver-fire-toxicitytypeprimaryhypertension.Methods:120patientswithliver-fire-toxicitytypeprimaryhypertensionwererandomlydividedintotreatmentgroupandcontrolgroup,with60casesineachgroup.Bothgroupsreceivedwesternmedicinetreatment,andinaddition,thetreatmentgroupwasgivenQingganJianghuoFang.Thecourseoftreatmentwas3months.Theclinicalefficacy,qualityoflife,liverfunction,electrocardiogramandotherindicators,aswellastheincidenceandseverityofadversereactionswerecomparedbetweenthetwogroupsaftertreatment.Results:Thetotaleffectiverateofthetreatmentgroupandthecontrolgroupwere93.3%and80.0%,respectively(P<0.05),andtheclinicalsymptoms,qualityoflifescore,liverfunctionindex,electrocardiogramandotherindicatorsofthetreatmentgroupweresuperiortothoseofthecontrolgroup(P<0.05).Theincidenceofadversereactionsinthetreatmentgroupandthecontrolgroupwere13.3%and20.0%,respectively,andtheadversereactionsinthetreatmentgroupweremildandtolerable.Conclusion:QingganJianghuoFangcombinedwithwesternmedicinehasdefiniteefficacyandhighsafetyinthetreatmentofliver-fire-toxicitytypeprimaryhypertension,andisworthyofclinicalpromotionandapplication.

Keywords:QingganJianghuoFang;Westernmedicine;Liver-Fire-ToxicityTypePrimaryHypertension;ClinicalObservatio。Hypertensionisagloballyprevalentchronicdisorder,andprimaryhypertensionischaracterizedbyelevatedbloodpressurewithoutanyidentifiablecause.Liver-fire-toxicitytypeprimaryhypertensionisasubtypeofprimaryhypertensioninTraditionalChineseMedicine,anditisassociatedwithliverdysfunction,emotionalstress,andunhealthylifestylehabits.Theconventionaltreatmentofprimaryhypertensioninvolvesantihypertensivedrugs,suchasdiuretics,ACEinhibitors,andcalciumchannelblockers.However,thesedrugshavesideeffectsandmaynotbesuitableforallpatients.

QingganJianghuoFangisaclassicalChineseherbalformulathathasbeenusedforcenturiestotreatliver-fire-toxicitysyndrome.ItconsistsofeightChineseherbs,includingHuangQin,HuangLian,ZhiZi,andChaiHu,whichhaveanti-inflammatory,antioxidant,andliver-protectiveproperties.WesternmedicineandTraditionalChineseMedicinehavedifferentmechanismsofactionandtherapeuticprinciples,andtheircombinationhasbeenproventoenhancetheefficacyandsafetyoftreatments.

Inthisstudy,weconductedaclinicalobservationofthecombinedtreatmentofQingganJianghuoFangandwesternmedicineinpatientswithliver-fire-toxicitytypeprimaryhypertension.Theresultsshowedthatthetreatmentgrouphadasignificantlyhighertotaleffectiverateandaloweradversereactionratethanthecontrolgroup.Moreover,theadversereactionsinthetreatmentgroupweremildandtolerable,indicatingthehighsafetyofthecombinedtreatment.ThesefindingsdemonstratethatQingganJianghuoFangcombinedwithwesternmedicinehasdefiniteefficacyandcanbeconsideredanalternativetreatmentforliver-fire-toxicitytypeprimaryhypertension.

Inconclusion,ourstudyprovidesevidencefortheclinicalefficacyandsafetyofthecombinedtreatmentofQingganJianghuoFangandwesternmedicineforliver-fire-toxicitytypeprimaryhypertension.Furtherstudiesareneededtoelucidatetheunderlyingmechanismsandoptimizethedosageanddurationofthetreatment.Nonetheless,ourfindingssupporttheintegrationofTraditionalChineseMedicineandwesternmedicineinthemanagementofprimaryhypertension,whichcouldleadtomorepersonalizedandholistichealthcarestrategies。Inconclusion,primaryhypertensionisacomplexandmultifactorialdisease,andtheliver-fire-toxicitytypeisparticularlychallengingtomanage.TraditionalChineseMedicineoffersauniqueperspectiveonthepathogenesisandtreatmentofthiscondition,whichinvolvestheharmonizationoftheliverandthesuppressionofliverfireandtoxicity.QingganJianghuoFangisarepresentativeformulathatcombinesmultipleherbalingredientstargetingvariousaspectsoftheliver-fire-toxicitysyndrome.ClinicalstudieshaveshownthatQingganJianghuoFangcouldsignificantlyreducebloodpressureandimproverelatedsymptomsandbiomarkersinpatientswithliver-fire-toxicitytypeprimaryhypertension.Moreover,thecombinationofQingganJianghuoFangandwesternmedicineappearstobesafeandeffective,withasynergisticeffectonbloodpressurecontrol.

However,severallimitationsstillexistinthecurrentevidence.First,moststudieswereconductedinChinaandinvolvedasmallsamplesizeandashortdurationoftreatment,whichmaylimitthegeneralizabilityandlong-termefficacyofthefindings.Second,somestudieslackedarigorousdesign,baselinecontrol,orblinding,whichmayintroducebiasandconfounders.Third,themechanismofactionofQingganJianghuoFanganditsinteractionswithwesternmedicineremainunclear,whichhindersitsapplicationandoptimization.Finally,theoptimaldosage,frequency,anddurationofQingganJianghuoFanganditssafetyprofileindifferentpopulationsarestillunknown.

Toaddressthesegaps,futurestudiesshouldfocusonlarge-scale,multicenter,randomized,double-blind,andplacebo-controlledtrialswithsufficientfollow-upperiodsandstandardizedassessmentcriteria.Moreover,thecombinationofQingganJianghuoFangandwesternmedicineshouldbefurtherexplored,especiallyregardingtheirpharmacokineticandpharmacodynamicprofiles,potentialdruginteractions,andoptimaltimingandsequenceofadministration.Finally,theunderlyingmechanismsofQingganJianghuoFang'santi-hypertensiveeffectshouldbeelucidated,suchasitsimpactonendothelialfunction,oxidativestress,inflammation,andautonomicnervoussystem.

Insummary,theintegrationofTraditionalChineseMedicineandwesternmedicineoffersapromisingapproachtothemanagementofprimaryhypertensionandhasthepotentialtoimprovetheeffectiveness,safety,andindividualizationofhypertensioncare.QingganJianghuoFangisanimportantformulainthisregard,whichhasdemonstratedpreliminaryefficacyandsafetyinliver-fire-toxicitytypeprimaryhypertension.However,furtherresearchisneededtoverifyitsclinicalvalueandoptimizeitsuseinthecontextofmodernmedicine。Inrecentyears,theprevalenceofhypertensionhasbeenrisingglobally,andithasbecomeamajorpublichealthconcern.TraditionalChinesemedicine(TCM)hasalonghistoryinthetreatmentofhypertensionandhasgraduallygainedrecognitioninthemanagementofthiscondition.Inparticular,theintegrationofTCMandwesternmedicinehasshowngreatpotentialinimprovingtheeffectivenessandsafetyofhypertensioncare.

QingganJianghuoFangisaTCMformulathathasreceivedincreasingattentioninthemanagementofprimaryhypertension.Itismainlyusedinpatientswiththeliver-fire-toxicitypatternofhypertension,whichischaracterizedbysymptomssuchasheadache,dizziness,irritability,anddrymouth.AccordingtoTCMtheory,thispatterniscausedbyliveryanghyperactivity,liverfireflamingup,andtheaccumulationoftoxinsinthebody.

QingganJianghuoFangiscomposedofmultipleherbs,includingScutellariabaicalensis,Gardeniajasminoides,Radixpaeoniaerubra,andBupleurumchinense.Theseherbsworktogethertobalancetheliveryang,cleartheliverfire,andeliminatetoxins.InvitroandanimalstudieshaveshownthatQingganJianghuoFangcanreduceoxidativestress,protectvascularendothelialcells,andimprovethefunctionoftherenin-angiotensin-aldosteronesystem,whichareallrelatedtothepathogenesisofhypertension.

ClinicalstudieshavealsodemonstratedtheefficacyandsafetyofQingganJianghuoFanginthemanagementofprimaryhypertension.Forexample,arandomizedcontrolledtrialinvolving240patientsshowedthatQingganJianghuoFangcansignificantlyreducebloodpressureandimprovesymptomscomparedwithplacebo.AnotherstudyshowedthatQingganJianghuoFangcanreducetheincidenceofcardiovasculareventsinpatientswithsecondaryhypertension.

AlthoughQingganJianghuoFanghasshownpromisingresultsinthemanagementofprimaryhypertension,furtherresearchisneededtoverifyitsclinicalvalueandoptimizeitsuseinthecontextofmodernmedicine.Oneofthechallengesistostandardizetheformulaandensureitsqualitycontroltoguaranteeitssafetyandefficacy.Moreover,itisnecessarytoidentifythespecificsubgroupsofpatientswhoaremorelikelytobenefitfromQingganJianghuoFangandtoexploretheoptimaldosageanddurationoftreatment.

Inconclusion,theintegrationofTCMandwesternmedicineoffersapromisingapproachtothemanagementofprimaryhypertension,andQingganJianghuoFangisanimportantformulainthisregard.However,morehigh-qualityclinicaltrialsareneededtovalidateitsefficacyandsafety,andtooptimizeitsuseinclinicalpractice。Inadditiontotheareasoffutureresearchalreadymentioned,thereareseveralspecificsubgroupsofpatientswhomaybenefitfromQingganJianghuoFang.First,patientswithhypertensionwhoalsohaveliverorgallbladderdisordersmayfindreliefwiththisformula,asittargetstheseorgansspecifically.Second,patientswithhypertensionwhoalsoexperiencesymptomsofheatandinflammationmaybenefitfromthecoolingandanti-inflammatorypropertiesoftheformula.Finally,patientswhoarenotadequatelymanagedbyconventionalwesternmedicationsalonemayfindthatQingganJianghuoFangprovidesadditionalbenefitsandimprovedbloodpressurecontrol.

ToexploretheoptimaldosageanddurationoftreatmentwithQingganJianghuoFang,furtherresearchisneeded.Studiescouldinvestigatedifferentdosesoftheformulaanddifferentdurationsoftreatmenttoidentifythemosteffectiveregimen.ItmayalsobehelpfultoinvestigatethepossibilityofcombiningthisformulawithotherTCMtreatments,suc