【目的】 分析六味安神胶囊联合氨氯地平贝那普利治疗老年原发性高血压（essential hypertension，EH）伴焦虑抑郁障碍 患者的临床疗效及对N-甲基-D-天冬氨酸受体2B亚基（NR2B）蛋白表达的干预作用。【方法】 选取该院老年科2020年12月至 2022年12月就诊的138例老年原发性高血压伴焦虑抑郁障碍痰热壅盛证患者进行回顾性研究，根据治疗方案的不同将患者 分为观察组和对照组，每组各69例。对照组给予氨氯地平贝那普利及常规心理治疗，观察组在对照组的基础上给予六味安 神胶囊治疗，疗程为1个月。观察2组患者治疗前后血压指标[收缩压（SBP）、舒张压（DBP）]、汉密尔顿焦虑量表（HAMA）评 分、汉密尔顿抑郁量表（HAMD）-17项评分、NR2B蛋白表达量、单胺类神经递质[多巴胺（DA）、肾上腺素（NE）、5-羟色胺 （5-HT）]的变化情况，并比较 2 组患者的临床疗效和不良反应总发生率。【结果】（1）治疗 1 个月后，观察组的总有效率为 95.65%（66/69），对照组为75.36%（52/69），组间比较（χ2检验），观察组的疗效明显优于对照组（P＜0.01）。（2）治疗后，2组患 者的SBP、DBP均较治疗前明显降低（P＜0.05），且观察组对SBP、DBP的降低作用均明显优于对照组（P＜0.01）。（3）治疗后， 2组患者的HAMA评分和HAMD-17项评分均较治疗前明显降低（P＜0.05），且观察组对HAMA评分和HAMD-17项评分的降 低作用均明显优于对照组（P＜0.01）。（4）治疗后，2组患者的 NR2B蛋白表达量均较治疗前明显降低（P＜0.05），且观察组对 NR2B蛋白表达量的降低作用明显优于对照组（P＜0.01）。（5）治疗后，2组患者的血清DA、NE、5-HT水平均较治疗前明显降 低（P＜0.05），且观察组对血清DA、NE、5-HT水平的降低作用均明显优于对照组（P＜0.01）。（6）观察组的不良反应总发生率 为2.90%（2/69），对照组为5.80%（4/69），组间比较，差异无统计学意义（P＞0.05）。【结论】 六味安神胶囊联合氨氯地平贝那 普利可有效减轻老年原发性高血压伴焦虑抑郁障碍痰热壅盛证患者的不良情绪，降低血压，抑制NR2B蛋白过度表达，纠正 单胺类神经递质紊乱，且联合治疗未引发严重不良反应，安全有效。

Objective To investigate the clinical efficacy of Liuwei Anshen Capsules combined with Amlodipine+ Benazepril Tablets in the treatment of senile essential hypertension（EH）patients complicated with anxiety and depressive disorders and its intervention effect on the expression of N-methyl-D-aspartate receptor 2B subunit （NR2B）protein. Methods A retrospective study was conducted on 138 senile EH patients complicated with anxiety and depressive disorders of accumulation of excess phlegm-heat syndrome treated in the Geriatric Department of Sinopharm Gezhouba Central Hospital from December 2020 to December 2022. The patients were divided into an observation group and a control group according to the treatment schemes，with 69 cases in each group. The control group was treated with Amlodipine+Benazepril Tablets and routine psychotherapy，and the observation group was treated with Liuwei Anshen Capsules orally on the basis of treatment for the control group. The course of treatment lasted for one month. The changes of blood pressure indicators of systolic blood pressure（SBP）and diastolic blood pressure（DBP）， Hamilton Anxiety Scale（HAMA）score， 17-Item Hamilton Depression Scale（HAMD-17） score，NR2B protein expression，and the levels of monoamine neurotransmitters of dopamine（DA），epinephrine （NE）， and 5-hydroxytryptamine（5-HT）in the two groups were observed before and after treatment. After treatment，the clinical efficacy and total incidence of adverse reactions were compared between the two groups. Results（1）After one month of treatment，the total effective rate of the observation group was 95.65%（66/69）， and that of the control group was 75.36%（52/69）. The intergroup comparison（tested by chi-square test）showed that the curative effect of the observation group was significantly superior to that of the control group（P＜0.01）. （2）After treatment，the SBP and DBP of the two groups were significantly decreased compared with those before treatment（P＜0.05），and the decrease of SBP and DBP in the observation group was significantly superior to that in the control group（P＜0.01）.（3）After treatment，the HAMA score and HAMD-17 score of the two groups were significantly decreased compared with those before treatment（P＜0.05），and the decrease of HAMA score and HAMD-17 score in the observation group was significantly superior to that in the control group （P＜0.01）. （4）After treatment，the expression level of NR2B protein in the two groups was significantly decreased compared with that before treatment（P＜0.05），and the decrease in the observation group was superior to that in the control group（P＜0.01）.（5）After treatment，the levels of serum DA，NE and 5-HT in the two groups were significantly decreased in comparison with those before treatment（P＜0.05），and the decrease of serum DA，NE and 5-HT levels in the observation group was significantly superior to that in the control group（P＜0.01）.（6）The total incidence of adverse reactions in the observation group was 2.90%（2/69）and that in the control group was 5.80% （4/69）. There was no significant difference between the two groups （P＞0.05）. Conclusion Liuwei Anshen Capsules combined with Amlodipine+Benazepril Tablets can effectively alleviate the bad mood， decrease blood pressure，inhibit the overexpression of NR2B protein，and correct the disorder of monoamine neurotransmitters in senile EH patients complicated with anxiety and depressive disorders of accumulation of excess phlegm-heat syndrome. The combined treatment does not cause serious adverse reactions，which is safe and effective.

R259.441；R277.7

国家自然科学基金资助项目（编号：82073824）