【摘要】 目的观察氯沙坦联合氨氯地平治疗老年高血压合并糖尿病的临床疗效。方法选择2012年12月~2014年12月在我院住院治疗的100例高血压合并2型糖尿病患者作为研究对象,根据治疗方法不同分为观察组(n=50)、对照组(n=50),两组患者均予控制饮食、口服降糖药或注射胰岛素及调脂治疗。观察组同时予氯沙坦50 mg/d,氨氯地平5 mg/d,每天晨顿服,如治疗4周后坐位血压未降至140/90 mm Hg,则氨氯地平每天改为10 mg,疗程12周。对照组予氯沙坦50 mg/d,每天1次,治疗4周后,若血压未降至参考范围则将剂量调至100 mg/d。比较两组治疗4周后的总有效率以及两组患者治疗前后血压、血糖的变化情况。结果观察组与对照组治疗后的显效率分别为50.0%、40.0%,组间比较无统计学意义(P>0.05),观察组与对照组治疗后的总有效率分别为96.0%和78.0%,组间比较具有统计学意义(P<0.05);两组患者的血压指标比较显示:治疗后,两组的SBP、DBP水平均较治疗前显著降低,且观察组的SBP、DBP水平显著低于对照组,差异具有显著性(P<0.05);两组患者的血糖指标比较显示:两组患者治疗4周后的Hb A1c水平较治疗前未见明显变化,组间比较也无统计学意义(P>0.05)。观察组患者治疗4周后的FPG、2 h PG均较治疗前显著降低,且显著低于对照组,差异均有统计学意义(P<0.05);但对照组患者治疗4周后的FPG、2 h PG较治疗前比较未见明显变化。结论氯沙坦联合氨氯地平治疗老年高血压合并糖尿病的临床疗效确切,可以显著降低血压、控制血糖水平,安全性好,值得推广和应用。更多还原

【Abstract】 Objective To observe the clinical efficacy of losartan combined with amlodipine in the treatment of elderly patients with hypertension and diabetes. Methods From December 2012 to December 2014 in our hospital,100 patients with hypertension and type 2 diabetes as the research object,according to the different treatment methods divided into observation group(n =50) and control group(n =50), two groups were given the control diet,oral hypoglycemic agents or insulin and lipid adjusting treatment. At the same time the observation group treated with losartan 50mg/d,amlodipine 5 mg/d, morning meal served every day after 4 weeks of treatment, such as sitting blood pressure not approaching 140/90 mm Hg,amlodipine every day was changed to 10 mg,the treatment course 12 weeks. The control group was treated with losartan 50 mg/d,1 times a day,4 weeks after the treatment,if the blood pressure did not drop to the reference range, changed the dose to 100 mg/d. After 4 weeks treatment,and the changes of the total efficiency of two groups of patients before and after the blood pressure,blood glucose were compared between two groups. Results The significant efficiency in observation group and the control group of patients after treatment were 50%,40%,had no significant difference between the groups(P>0.05),the total effective rate the observation group and the control group after the treatment were 96% and 78%,the difference was significant between two groups(P<0.05). The SBP level of DBP of two groups decreased significantly at the end of treatment,the SBP level of DBP of observation group was significantly lower than the control group, there were significant differences(P<0.05); After 4 weeks of treatment, the Hb A1 c level of two groups had no significant difference(P>0.05). After 4 weeks of treatment,FPG,2 h PG of observation group were significantly lower, and significantly lower than the control group, there were significant differences(P<0.05);after 4 weeks of treatment, FPG,2 h PG of the observation group compared with those before treatment, there were no significant changes. Conclusion The clinical efficacy of losartan combined with amlodipine in the treatment of senile hypertension complicated with diabetes mellitus is exactly, and can significantly reduce blood pressure, control blood sugar levels, the security is good, worthy of promotion and application.更多还原