探讨活血益气方（由红花、山楂、丹参、黄芪4种中药组成）联合平肝潜阳沐足散（由钩藤、夏枯草、菊花、金 银花和决明子5种中药组成）对原发性高血压女性患者血脂代谢及心功能的影响。【方法】 将220例气虚血瘀型原发性高血压 女性患者随机分为观察组和对照组，每组各110例。对照组给予常规西药治疗，观察组在对照组的基础上给予活血益气方联 合平肝潜阳沐足散治疗，疗程为1个月。观察2组患者治疗前后血压、血脂、中医证候积分以及心功能指标[左心室射血分数 （LVEF）、每搏输出量（SV）]的变化情况，并评价2组患者的临床疗效。【结果】（1）疗效方面，治疗1个月后，观察组的总有效 率为95.45%（105/110），对照组为84.55%（93/110），组间比较（χ2 检验），观察组的疗效明显优于对照组（P＜0.01）。（2）中医证 候评分方面，治疗后，2组患者的主症积分和次症积分均较治疗前降低（P＜0.05），且观察组对主症积分和次症积分的降低 幅度均明显优于对照组（P＜0.01）。（3）血压方面，治疗后，2组患者的收缩压（SBP）、舒张压（DBP）水平均较治疗前降低（P＜ 0.05），且观察组对 SBP、DBP 水平的降低幅度均明显优于对照组（P＜0.01）。（4）血脂方面，治疗后，2 组患者的总胆固醇 （TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）水平均较治疗前降低（P＜0.05），高密度脂蛋白胆固醇（HDL-C）水平均 较治疗前升高（P＜0.05），且观察组对TC、TG、LDL-C水平的降低幅度及对HDL-C水平的升高幅度均明显优于对照组（P＜ 0.01）。（5）心功能方面，治疗后，2组患者的LVEF、SV水平均较治疗前升高（P＜0.05），且观察组对LVEF、SV水平的升高幅 度均明显优于对照组（P＜0.01）。【结论】 活血益气方联合平肝潜阳沐足散治疗气虚血瘀型原发性高血压女性患者疗效确切， 能够有效控制血压，改善血脂代谢水平及心功能。

To investigate the effects of Huoxue Yiqi Decoction （composed of Carthami Flos，Crataegi Fructus，Salviae Miltiorrhizae Radix et Rhizoma，and Astragali Radix） combined with Pinggan Qianyang Muzu Powder （composed of Uncariae Ramulus cum Uncis，Prunellae Spica，Chrysanthemi Flos，Lonicerae Japonicae Flos and Cassiae Semen） on blood lipid metabolism and cardiac function in female patients with essential hypertension. Methods A total of 220 female patients with essential hypertension of qi deficiency and blood stasis type were randomly divided into observation group and control group，with 110 cases in each group. The control group was treated with conventional western medicine，and the observation group was treated with Huoxue Yiqi Decoction orally combined with Pinggan Qianyang Muzu Powder for foot bath on the basis of treatment for the control group. The course of treatment for the two groups covered one month. Before and after treatment，the two groups were observed in the changes of blood pressure， blood lipid， traditional Chinese medicine（TCM） syndrome scores and cardiac function indicators of left ventricular ejection fraction（LVEF） and stroke volume （SV）. After treatment， the clinical efficacy of the two groups was evaluated. Results （1）After one month of treatment，the total effective rate of the observation group was 95.45% （105/110），and that of the control group was 84.55%（93/110）. The intergroup comparison （tested by chi-square test） showed that the efficacy of the observation group was superior to that of the control group （P＜0.01）.（2）After treatment，the TCM syndrome scores of primary symptoms and secondary symptoms in the two groups were decreased when compared with those before treatment （P＜0.05），and the decrease in the observation group was superior to that in the control group （P＜0.01 ）.（3） After treatment，the levels of systolic blood pressure （SBP） and diastolic blood pressure （DBP） in the two groups were lower than those before treatment （P＜0.05），and the decrease of SBP and DBP levels in the observation group was significantly superior to that in the control group （P＜0.01）.（4） After treatment，the levels of blood lipid indicators of total cholesterol （TC），triglyceride （TG） and low density lipoprotein cholesterol （LDL-C） in the two groups were lower than those before treatment （P＜0.05）， and the levels of high density lipoprotein cholesterol （HDL-C） were higher than those before treatment （P＜0.05）. The decrease of TC，TG and LDL-C levels and the increase of HDL-C level in the observation group were significantly superior to those in the control group （P＜0.01）.（5） After treatment，the levels of cardiac function indicators of LVEF and SV in the two groups were higher than those before treatment （P＜0.05）， and the increase of LVEF and SV levels in the observation group was significantly superior to that in the control group （P＜0.01）. Conclusion The combination of Huoxue Yiqi Decoction and Pinggan Qianyang Muzu Powder exerts certain effect in the treatment of female patients with essential hypertension of qi deficiency and blood stasis type. The combined therapy is effective on controlling blood pressure，improving blood lipid metabolism and cardiac function indicators.

R259.441

国家重点研发计划项目（编号：2018YFC2002002）