中华中医药学刊

针刺联合六味地黄丸加味干预老年卒中伴高血压（肝肾阴虚型）的临床观察及对血压水平影响

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姜铭 ¹ , 姚锐 ² , 袁维运 ¹

中华中医药学刊 | 国家项目点击 2026,44(3): 180-184

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中华中医药学刊 |国家项目点击 2026 , 44 (3) : 180 -184

针刺联合六味地黄丸加味干预老年卒中伴高血压（肝肾阴虚型）的临床观察及对血压水平影响

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姜铭¹, 姚锐², 袁维运¹

作者信息

^1.中国人民解放军空军军医大学附属第一医院，陕西西安 710032

^2.西安市人民医院（西安市第四医院），陕西西安 710199

通讯作者:

姚锐（1986 -），女，陕西西安人，副主任药师，博士，研究方向：中药新药临床与研用。E-mail：331703876@qq.com。

作者简介:

姜铭（1981 -），男，陕西榆林人，副主任医师，博士，研究方向：针灸在现代康复领域中的应用。

Clinical Observation of Acupuncture Combined with Modified Liuwei Dihuang Pill（六味地黄丸加味）in Intervention of Elderly Stroke Patients with Hypertension（Yin Deficiency of Liver and Kidney Type）and Its Effect on Blood Pressure Levels in Patients

Ming JIANG¹, Rui YAO², Weiyun YUAN¹

Affiliations

^1.The First Affiliated Hospital of Air Force Medical University, Xi＇an 710032, Shaanxi, China

^2.Xi＇an People＇s Hospital(Xi＇an Fourth Hospital), Xi＇an 710199, Shaanxi, China

出版时间: 2026-03-10 doi: 10.13193/j.issn.1673-7717.2026.03.033

文章导航

摘要

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目的

观察针刺联合六味地黄丸加味干预老年卒中伴高血压患者（肝肾阴虚型）的临床观察及对患者血压水平影响。

方法

选择2021年1月—2024年1月于空军军医大学附属医院中医科治疗的110例老年卒中伴高血压患者，采用随机数字表法将其分为对照组和试验组，每组55例，对照组采用硝苯地平控释片治疗，试验组同时采用针刺联合六味地黄丸加味治疗。比较两组临床疗效、血压、血脂水平和安全性。

结果

试验组有效率（94.55%，52/55）明显优于对照组（83.64%，46/55）。与干预前比较，两组患者的收缩压和舒张压在干预4、8周后均明显下调（P < 0.05）；与对照组比较，试验组患者的收缩压和舒张压在干预4、8周后均明显下调（P < 0.05）。与干预前比较，两组患者的总胆固醇（Total cholesterol，TC）、甘油三酯（Triglycerides，TG）、低密度脂蛋白胆固醇（Low-density lipoprotein cholesterol，LDL-C）在干预4、8周后均明显下调，而高密度脂蛋白胆固醇（High density lipoprotein cholesterol，HDL-C）水平明显上调（P < 0.05）；与对照组比较，试验组患者的TC、TG、LDL-C在干预4、8周后均明显下调，而HDL-C水平明显上调（P < 0.05）。与干预前比较，两组患者的美国国立卫生研究院卒中量表评分（National Institutes of Health Stroke Scale，NIHSS评分）在干预4、8周后均明显下调（P < 0.05）；与对照组比较，试验组患者的NIHSS评分在干预4、8周后均明显下调（P < 0.05）。与干预前比较，两组患者的卒中生存质量量表评分（Stroke-Specific Quality of Life Scale，SS-QOL评分）在干预4、8周后均明显上调（P < 0.05）；与对照组比较，试验组患者的SS-QOL评分在干预4、8周后均明显上调（P < 0.05）。干预期间，患者主要不良反应有恶心呕吐、食欲不振、心慌胸闷、头晕头痛等，但两组不良反应总发生率差异无统计学意义（P > 0.05）。

结论

针刺联合六味地黄丸加味干预老年卒中伴高血压患者（肝肾阴虚型）临床疗效显著，能够更平稳地控制患者的收缩压和舒张压，并降低血脂，改善卒中患者的神经、肢体功能，且安全性较高。

关键词

高血压 / 脑卒中 / 老年 / 血压 / 血脂 / 针刺 / 六味地黄丸

Abstract

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Objective

To observe the clinical effect of acupuncture combined with Modified Liuwei Dihuang Pill（六味地黄丸加味）on the elderly stroke patients with hypertension（Yin deficiency of liver and kidney type）and its impact on blood pressure levels.

Methods

A hundred and ten elderly stroke patients with hypertension treated in the Traditional Chinese Medicine Department of The Affiliated Hospital of Air Force Medical University from January 2021 to January 2024 were randomly divided into a control group and an experimental group, with 55 patients in each group. The control group was treated with nifedipine controlled-release tablets, while the experimental group was treated with acupuncture combined with Modified Liuwei Dihuang Pills. The clinical efficacy, blood pressure, blood lipid levels and safety were compared between two groups.

Results

The effective rate of the experimental group（94.55%, 52/55）was significantly better than that of the control group（83.64%, 46/55）. Compared with those before intervention, the systolic and diastolic blood pressures of the patients in both groups were significantly reduced after 4 and 8 weeks of intervention（P < 0.05）. Compared with those in the control group, the systolic and diastolic blood pressures of the patients in the experimental group were significantly reduced after intervention for 4 and 8 weeks（P < 0.05）. Compared with those before intervention, the levels of TC, TG and LDL-C in both groups were significantly down-regulated after 4 and 8 weeks of intervention, while the level of HDL-C was significantly up-regulated（P < 0.05）. Compared with those of the control group, the levels of TC, TG and levels of the experimental group were significantly down regulated after 4 and 8 weeks of intervention, while the HDL-C level was significantly up-regulated（P < 0.05）. Compared with those before intervention, the NIHSS scores of both groups were significantly reduced after 4 and 8 weeks of intervention（P < 0.05）. Compared with those of the control group, the NIHSS scores of the experimental group were significantly reduced after 4 and 8 weeks of intervention（P < 0.05）. Compared with those before intervention, the SS-QOL scores of both groups were significantly up-regulated after 4 and 8 weeks of intervention（P < 0.05）. Compared with those in the control group, the SS-QOL scores of the patients in the experimental group were significantly up-regulated after 4 and 8 weeks of intervention（P < 0.05）. During the pre-treatment period, the main adverse reactions of the patients included nausea and vomiting, loss of appetite, palpitations and chest tightness, dizziness and headache, but there was no significant difference in the total incidence of adverse reactions between the two groups（P > 0.05）.

Conclusion

Acupuncture combined with Modified Liuwei Dihuang Pills can achieve better clinical efficacy in the elderly stroke patients with hypertension（Yin deficiency of liver and kidney type）. It can control the systolic and diastolic blood pressures more smoothly, reduce the blood lipids, improve the neurological and limb functions of the stroke patients, and has higher safety.

Key words

hypertension / stroke / elderly / blood pressure / blood lipids / acupuncture / Liuwei Dihuang Pill（六味地黄丸）

引用本文

姜铭, 姚锐, 袁维运. 针刺联合六味地黄丸加味干预老年卒中伴高血压（肝肾阴虚型）的临床观察及对血压水平影响. 中华中医药学刊, 2026 , 44 (3) : 180 -184 . DOI: 10.13193/j.issn.1673-7717.2026.03.033

Ming JIANG, Rui YAO, Weiyun YUAN. Clinical Observation of Acupuncture Combined with Modified Liuwei Dihuang Pill（六味地黄丸加味）in Intervention of Elderly Stroke Patients with Hypertension（Yin Deficiency of Liver and Kidney Type）and Its Effect on Blood Pressure Levels in Patients[J]. Chinese Archives of Traditional Chinese Medicine, 2026 , 44 (3) : 180 -184 . DOI: 10.13193/j.issn.1673-7717.2026.03.033

基金

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国家自然科学基金青年科学基金项目(81904006)
陕西省自然科学基础研究计划项目(2020JQ-863)

参考文献

收起

文献

收起

参考文献引证文献

排序方式：

［1］

郭航，赵春燕，战丽彬，等.基于网络药理学的六味地黄丸治疗高血压、2型糖尿病、阿尔茨海默病的异病同治机制分析［J］.中药药理与临床，2021，37（1）：41-49.

［2］

吉哲敏，徐强.六味地黄丸加减治疗眩晕验案心悟［J］.光明中医，2020，35（20）：3281-3283.

［3］

颜晓睿，隋国媛，贾连群.六味地黄丸联合西药治疗高血压病效果的Meta分析［J］.中华中医药学刊，2021，39（1）：127-131.

［4］

毛小静，范金茹，陈彤，等.王行宽治疗风眩经验［J］.河南中医，2020，40（5）：733-734.

［5］

YANG N, CHOU H D, WEI M T, et al. Association between obstructive sleep apnea and vascular injury in hypertensive patients［J］. Zhonghua Xinxueguanbing Zazhi, 2023, 51（11）：1137-1144.

［6］

王梦楠，刘军红，张瑞芳，等.厄贝沙坦联合六味地黄丸对阴虚阳亢型原发性高血压伴早期肾损害病人炎性因子的影响［J］.中西医结合心脑血管病杂志，2020，18（4）：635-638.

［7］

宋丽静，王明，胡沙欧.熄风调督毫针刺法联合康复训练治疗原发性高血压合并急性缺血性脑卒中临床研究［J］.新中医，2024，56（10）：126-131.

［8］

王君，王娟，张理想.高血压合并脑卒中住院患者的预后情况及影响因素［J］.中国卫生工程学，2023，22（6）：857-859.

［9］

ARMAS-PADRÓN A M, SICILIA-SOSVILLA M, RUIZ-ESTEBAN P, et al. Cardiovascular health and target end-organ damage and comorbidities in hypertensive patients from a Spanish primary care urban population［J］. Nefrologia（Engl Ed）, 2024, 44（1）：77-89.

［10］

CHUA J, WONG D, YOW A P, et al. Segregation of neuronal and vascular retinal damage in patients with hypertension and diabetes［J］. Ann N Y Acad Sci, 2024, 1531（1）：49-59.

［11］

BRODSKIY I, FOGEL J, DOUEN A, et al. Hypertension and gastrointestinal bleed in COVID-19 patients：associations with mortality, acute kidney injury, vasopressor use, and mechanical ventilation use［J］. Folia Med Cracov, 2023, 63（4）：99-108.

［12］

XIAO Y, ZHOU Z Y, SUN J C, et al. Protective effect of novel angiotensin receptor neprilysin inhibitor S086 on target organ injury in spontaneously hypertensive rats［J］. Biomed Pharmacother, 2024, 170：115968.

［13］

CARNEVALE L, PERROTTA M, MASTROIACOVO F, et al. Advanced magnetic resonance imaging to define the microvascular injury driven by neuroinflammation in the brain of a mouse model of hypertension［J］. Hypertension, 2024, 81（3）：636-647.

［14］

ZHANG X, YUAN Y, LI C, et al.替代食盐对血压正常成年人高血压和低血压发病率的影响［J］.中华高血压杂志（中英文）, 2024, 32（6）：528.

［15］

李亚茹，王楠，葛智文，等. Cox回归分析模型与决策树模型识别中老年高血压发病危险因素的效果比较［J］.公共卫生与预防医学，2024，35（4）：24-27.

［16］

COSTA R M, CERQUEIRA D M, BRUDER-NASCIMENTO A, et al. Role of the CCL5 and its receptor, CCR5, in the genesis of aldosterone-induced hypertension, vascular dysfunction, and end - organ damage［J］. Hypertension, 2024, 81（4）：776-786.

［17］

CÍFKOVÁ R, HARAZNY J M, BRUTHANS J, et al. Early vascular damage in retinal microcirculation in arterial hypertension：the Czech post-MONICA study［J］. J Hypertens, 2024, 42（3）：557-563.

［18］

WANG W J, LI G D, MA J, et al. Microvascular rarefaction caused by the NOTCH signaling pathway is a key cause of TKI-apatinib - induced hypertension and cardiac damage［J］. Front Pharmacol, 2024, 15：1346905.

［19］

HEITAKU S, SASASE T, SOTANI T, et al. JTT-654, an 11-beta hydroxysteroid dehydrogenase type 1 inhibitor, improves hypertension and diabetic kidney injury by suppressing angiotensinogen production［J］. J Pharmacol Sci, 2024, 154（4）：246-255.

［20］

张裕.“活血散风”针刺法对正常高值血压人群临床症状及血管功能的影响［D］.北京：北京中医药大学，2023.

［21］

曹蓓迪，李波漩，孟智宏.针刺治疗高血压病时效关系述评［J］.中国中医基础医学杂志，2023，29（6）：987-990.

［22］

李会娟，高鹤，申鹏飞.“活血散风，调和肝脾”针刺法对高血压合并腹泻型肠易激综合征症状改善的临床观察［J］.中华中医药杂志，2022，37（11）：6859-6863.

［23］

黄晋晨.活血散风针刺法辅助治疗对老年卒中合并高血压患者神经肢体功能、血压和生活质量的影响［J］.中外医学研究，2023，21（6）：57-60.

［24］

ZHOU R, YANG H J, ZHU P, et al. Effect of gut microbiota on the pharmacokinetics of nifedipine in spontaneously hypertensive rats［J］. Pharmaceutics, 2023, 15（8）：2085.

［25］

OU M H, ZHANG F T, CUI S C, et al. Oral nifedipine may be a preferential option for treating acute severe hypertension during pregnancy：a meta-analysis［J］. Hypertens Pregnancy, 2023, 42（1）：2209637.

［26］

LI L, XIE W, XU H, et al. Oral nifedipine versus intravenous labetalol for hypertensive emergencies during pregnancy：a systematic review and meta-analysis［J］. J Matern Fetal Neonatal Med, 2023, 36（2）：2235057.

［27］

PRATT K, LORDO R, SELF S, et al. Amlodipine versus nifedipine ER for the management of postpartum hypertension：a noninferiority randomized controlled trial［J］. Am J Obstet Gynecol MFM, 2025, 7（1）：101575.

［28］

施明.张钟爱教授治疗老年高血压病的经验［J］.中医临床研究，2021，13（12）：48-50.

［29］

林小凤，青姚，钟娟.六味地黄丸加减联合电针治疗老年高血压合并失眠的临床疗效观察［J］.中国社区医师，2021，37（13）：92-93，96.

［30］

杜柏荣，赵桂良，程俊文，等.六味地黄丸加减治疗肝肾阴虚型高血压病眩晕的疗效与机制研究［J］.中药材，2021，44（6）：1511-1515.

［31］

刘云宽，高敏，林柳任，等.基于网络药理学的六味地黄丸治疗高血压作用机制探讨［J］.中国现代中药，2021，23（7）：1221-1229.

［32］

董月桂，易健，刘柏炎.六味地黄丸联合奥美沙坦酯片治疗高血压病早期肾损伤34例［J］.湖南中医杂志，2021，37（8）：45-47.

［33］

李波，王建发，刘景委，等.加味六味地黄颗粒联合常规治疗对老年高血压合并认知障碍患者的临床疗效［J］.中成药，2022，44（12）：3842-3847.

［34］

王雁，苏春燕，许慧荣.六味地黄丸合丹栀逍遥散加减及辨证施护对H型高血压阴虚阳亢证患者血压水平及综合疗效的影响［J］.大医生，2023，8（2）：96-99.

［35］

张庆，郭麦平，姚姗姗，等.六味地黄滴丸联合常规西药治疗原发性高血压阴虚阳亢证的临床研究［J］.中西医结合心脑血管病杂志，2023，21（12）：2273-2277.

2026年第44卷第3期

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doi: 10.13193/j.issn.1673-7717.2026.03.033

首发时间：2026-10-14
出版时间：2026-03-10

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基金

国家自然科学基金青年科学基金项目(81904006)

陕西省自然科学基础研究计划项目(2020JQ-863)

作者信息

^1.中国人民解放军空军军医大学附属第一医院，陕西西安 710032

^2.西安市人民医院（西安市第四医院），陕西西安 710199

通讯作者:

姚锐（1986 -），女，陕西西安人，副主任药师，博士，研究方向：中药新药临床与研用。E-mail：331703876@qq.com。

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https://castjournals.cast.org.cn/joweb/zhzyyxk/CN/10.13193/j.issn.1673-7717.2026.03.033

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

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