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Article(id=1322926825818698684, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926740955341011, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.10.008, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339934067, onlineDateStr=2026-10-30, pubDate=1760025600000, pubDateStr=2025-10-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339934067, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339934067, creator=13701087609, updateTime=1793339934067, updator=13701087609, issue=Issue{id=1322926740955341011, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='10', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1760025600000', pubDateStr='2025-10-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339913834, creator='13701087609', updateTime=1793340753123, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322930261259846420, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926740955341011, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322930261259846421, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926740955341011, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=41, endPage=44, ext={EN=ArticleExt(id=1322926826020025277, articleId=1322926825818698684, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Study on Mechanism and Effect of Tianma Gouteng Yin（天麻钩藤饮）in Treatment of Mitochondrial Protein Pathway Regulated by Hypertension, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the therapeutic effect of Tianma Gouteng Yin（天麻钩藤饮）on hypertension and the mechanism of regulating mitochondrial protein pathway.

Methods

Ninety-two patients with hypertension admitted to the hospital from January 2023 to December 2023 were included as study objects，and were divided into two groups by random number table method.Forty-six patients in the control group were treated with nifedipine sustained-release tablet，and the other forty-six patients in the observation group were treated with Tianma Gouteng Yin on this basis.The curative effect，blood pressure level，symptom score，oxidative stress index and mitochondrial fusion protein level were compared between the two groups.

Results

The total curative effect rate of the observation group was 95.65%（44/46），which was much higher than that of the control group（76.09%，35/46），and the difference was significant（P<0.05）.After treatment，the systolic blood pressure，diastolic blood pressure，vertigo，headache，lumbo-knee acid and five upset heat in the observation group were lower than those in the control group（P<0.05）.After treatment，the levels of glutathione peroxidase（GSH-Px）and superoxide dismutase（SOD）in the observation group were higher than those in the control group，the levels of malondialdehyde（MDA）and reactive oxygen species（ROS）were lower than those in the control group（P<0.05）.After treatment，the levels of recombinant mitofusin 1（MFN1），recombinant mitofusin 2（MFN2）and optic nerve atrophy protein 1（OPA1）in the observation group were higher than those in the control group（P<0.05）.

Conclusion

The application of Tianma Gouteng Yin in the treatment of hypertensive patients can effectively improve the symptoms of patients，reduce the level of blood pressure，delay the effect of vascular aging by enhancing the expression of mitochondrial fusion protein，reduce the oxidative stress reaction，improve the clinical efficacy，and has high application value.

, authors=Junwei PAN, Quan PAN, Xiaofeng LUO, authorsList=Junwei PAN, Quan PAN, Xiaofeng LUO, authorCompany=null, correspAuthors=Quan PAN, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322926828817626056, articleId=1322926825818698684, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=天麻钩藤饮治疗高血压调控线粒体蛋白通路的机制与疗效研究, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=
目的

分析天麻钩藤饮治疗高血压的疗效及其调控线粒体蛋白通路的机制。

方法

纳入2023年1月—2023年12月医院收治的92例高血压患者为研究对象，随机数字表法将其分为两组，46例对照组采用硝苯地平缓释片治疗，46例观察组在此基础上联合天麻钩藤饮治疗，对比两组疗效差异、血压水平、症状积分、氧化应激指标、线粒体融合蛋白等指标水平变化情况。

结果

观察组总疗效率为95.65%（44/46），远高于对照组的76.09%（35/46），组间比较差异有统计学意义（P<0.05）；治疗后观察组收缩压、舒张压、眩晕、头痛、腰膝酸和五心烦热四项症状评分低于对照组（P<0.05）；治疗后观察组谷胱甘肽过氧化物酶（Glutathione peroxidase，GSH-Px）、SOD活性氧（Reactive oxygen species，ROS）高于对照组，丙二醛（Malondialdehyde，MDA）、活性氧（Reactive oxygen species，ROS）低于对照组（P<0.05）；治疗后观察组线粒体融合蛋白1（Recombinant mitofusin 1，MFN1）、线粒体融合蛋白2（Recombinant mitofusin 2，MFN2）、OPA1视神经萎缩蛋白1（Autosomal dominant optic atrophy，ADOA）高于对照组（P<0.05）。

结论

对高血压患者应用天麻钩藤饮治疗可有效改善患者症状，降低其血压水平，通过增强线粒体融合蛋白的表达来延缓血管的衰老，减轻氧化应激反应，提高临床疗效，应用价值较高。

, authors=潘军伟, 潘铨, 罗晓风, authorsList=潘军伟, 潘铨, 罗晓风, authorCompany=null, correspAuthors=潘铨, authorNote=

潘军伟（1978-），男，浙江丽水人，副主任中医师，研究方向：中医药防治心脑血管疾病。

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潘铨（1980-），男，安徽黄山人，主任中医师，硕士，研究方向：中医药防治心血管疾病。E-mail：。
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潘军伟（1978-），男，浙江丽水人，副主任中医师，研究方向：中医药防治心脑血管疾病。

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潘军伟（1978-），男，浙江丽水人，副主任中医师，研究方向：中医药防治心脑血管疾病。

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组别例数显效有效无效总有效
观察组4632（69.57）12（26.09）2（4.35）44（95.65）
对照组4620（43.48）15（32.61）11（23.91）35（76.09）
χ2值7.256
P值0.007
), ArticleFig(id=1322926830839280614, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926825818698684, language=CN, label=表1, caption=

两组高血压患者治疗效果比较

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组别例数显效有效无效总有效
观察组4632（69.57）12（26.09）2（4.35）44（95.65）
对照组4620（43.48）15（32.61）11（23.91）35（76.09）
χ2值7.256
P值0.007
), ArticleFig(id=1322926830923166695, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926825818698684, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数收缩压舒张压
治疗前治疗后t值P值治疗前治疗后t值P值
观察组46159.72±8.62123.52±7.62*#21.3400.000110.62±8.6283.62±5.12*#18.2650.000
对照组46159.76±8.13136.52±5.63*15.9380.000110.45±7.6289.92±6.52*13.8840.000
t值0.0239.3060.1005.154
P值0.9820.0000.9200.000
), ArticleFig(id=1322926830986081256, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926825818698684, language=CN, label=表2, caption=

两组高血压患者血压水平比较（）

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组别例数收缩压舒张压
治疗前治疗后t值P值治疗前治疗后t值P值
观察组46159.72±8.62123.52±7.62*#21.3400.000110.62±8.6283.62±5.12*#18.2650.000
对照组46159.76±8.13136.52±5.63*15.9380.000110.45±7.6289.92±6.52*13.8840.000
t值0.0239.3060.1005.154
P值0.9820.0000.9200.000
), ArticleFig(id=1322926831053190121, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926825818698684, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间眩晕头痛腰膝酸软五心烦热
观察组46治疗前1.78±0.431.69±0.361.52±0.301.57±0.32
治疗后0.75±0.23*#0.70±0.19*#0.63±0.16*#0.58±0.17*#
t值14.32616.49517.75418.530
P值0.0000.0000.0000.000
对照组46治疗前1.80±0.461.71±0.371.50±0.281.56±0.35
治疗后0.97±0.31*0.88±0.25*0.81±0.23*0.73±0.20*
t值10.14812.60712.91513.965
P值0.0000.0000.0000.000
治疗前t值0.2150.2630.3310.143
治疗前P值0.8290.7930.7420.887
治疗后t值3.8663.8884.3573.876
治疗后P值0.0000.0000.0000.000
), ArticleFig(id=1322926831124493290, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926825818698684, language=CN, label=表3, caption=

两组高血压患者症状积分水平比较

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组别例数时间眩晕头痛腰膝酸软五心烦热
观察组46治疗前1.78±0.431.69±0.361.52±0.301.57±0.32
治疗后0.75±0.23*#0.70±0.19*#0.63±0.16*#0.58±0.17*#
t值14.32616.49517.75418.530
P值0.0000.0000.0000.000
对照组46治疗前1.80±0.461.71±0.371.50±0.281.56±0.35
治疗后0.97±0.31*0.88±0.25*0.81±0.23*0.73±0.20*
t值10.14812.60712.91513.965
P值0.0000.0000.0000.000
治疗前t值0.2150.2630.3310.143
治疗前P值0.8290.7930.7420.887
治疗后t值3.8663.8884.3573.876
治疗后P值0.0000.0000.0000.000
), ArticleFig(id=1322926831187407851, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926825818698684, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间MDA/（μmol/L）GSH-Px/（U/mL）SOD/（U/mL）ROS/（U/mL）
观察组46治疗前13.52±2.14 116.52±23.52 4.24±2.14 1 182.52±512.54
治疗后4.25±3.15*#170.52±19.25*#9.56±2.16*#759.52±315.27*#
t值16.50912.05011.8674.768
P值0.0000.0000.0000.000
对照组46治疗前13.55±2.15 116.85±25.46 4.15±1.24 1 190.42±519.82
治疗后8.52±2.11*152.45±22.14*6.58±2.17*985.45±248.76*
t值11.3257.1566.5942.412
P值0.0000.0000.0000.000
治疗前t值0.0670.0650.2470.073
治疗前P值0.9470.9490.8060.942
治疗后t值7.6394.3266.6013.816
治疗后P值0.0000.0000.0000.000
), ArticleFig(id=1322926831258711020, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926825818698684, language=CN, label=表4, caption=

两组高血压患者应激反应指标水平比较（）

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组别例数时间MDA/（μmol/L）GSH-Px/（U/mL）SOD/（U/mL）ROS/（U/mL）
观察组46治疗前13.52±2.14 116.52±23.52 4.24±2.14 1 182.52±512.54
治疗后4.25±3.15*#170.52±19.25*#9.56±2.16*#759.52±315.27*#
t值16.50912.05011.8674.768
P值0.0000.0000.0000.000
对照组46治疗前13.55±2.15 116.85±25.46 4.15±1.24 1 190.42±519.82
治疗后8.52±2.11*152.45±22.14*6.58±2.17*985.45±248.76*
t值11.3257.1566.5942.412
P值0.0000.0000.0000.000
治疗前t值0.0670.0650.2470.073
治疗前P值0.9470.9490.8060.942
治疗后t值7.6394.3266.6013.816
治疗后P值0.0000.0000.0000.000
), ArticleFig(id=1322926831334208493, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926825818698684, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间MFN1MFN2OPA1
观察组46治疗前4.19±0.282.19±0.244.11±0.23
治疗后5.68±0.21*#5.19±0.14*#5.19±0.24*#
t值28.87373.23022.035
P值0.0000.0000.000
对照组46治疗前4.17±0.212.17±0.244.09±0.24
治疗后5.01±0.28*4.02±0.14*4.59±0.27*
t值16.27845.1599.387
P值0.0000.0000.000
治疗前t值0.3880.4000.408
治疗前P值0.6990.6900.684
治疗后t值12.98340.07911.265
治疗后P值0.0000.0000.000
), ArticleFig(id=1322926831397123054, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926825818698684, language=CN, label=表5, caption=

两组高血压患者线粒体融合蛋白相关指标比较()

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组别例数时间MFN1MFN2OPA1
观察组46治疗前4.19±0.282.19±0.244.11±0.23
治疗后5.68±0.21*#5.19±0.14*#5.19±0.24*#
t值28.87373.23022.035
P值0.0000.0000.000
对照组46治疗前4.17±0.212.17±0.244.09±0.24
治疗后5.01±0.28*4.02±0.14*4.59±0.27*
t值16.27845.1599.387
P值0.0000.0000.000
治疗前t值0.3880.4000.408
治疗前P值0.6990.6900.684
治疗后t值12.98340.07911.265
治疗后P值0.0000.0000.000
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天麻钩藤饮治疗高血压调控线粒体蛋白通路的机制与疗效研究
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潘军伟 , 潘铨 , 罗晓风
中华中医药学刊 | 国家项目点击 2025,43(10): 41-44
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中华中医药学刊 |国家项目点击 2025 , 43 (10) : 41 -44
天麻钩藤饮治疗高血压调控线粒体蛋白通路的机制与疗效研究
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潘军伟, 潘铨 , 罗晓风
作者信息
  • 丽水市中医院，浙江 丽水 323000
通讯作者:
潘铨（1980-），男，安徽黄山人，主任中医师，硕士，研究方向：中医药防治心血管疾病。E-mail：。
作者简介:

潘军伟（1978-），男，浙江丽水人，副主任中医师，研究方向：中医药防治心脑血管疾病。

Study on Mechanism and Effect of Tianma Gouteng Yin（天麻钩藤饮）in Treatment of Mitochondrial Protein Pathway Regulated by Hypertension
Junwei PAN, Quan PAN , Xiaofeng LUO
Affiliations
  • Lishui Hospital of Traditional Chinese Medicine，Lishui 323000，Zhejiang，China
出版时间: 2025-10-10 doi: 10.13193/j.issn.1673-7717.2025.10.008
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摘要
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目的

分析天麻钩藤饮治疗高血压的疗效及其调控线粒体蛋白通路的机制。

方法

纳入2023年1月—2023年12月医院收治的92例高血压患者为研究对象，随机数字表法将其分为两组，46例对照组采用硝苯地平缓释片治疗，46例观察组在此基础上联合天麻钩藤饮治疗，对比两组疗效差异、血压水平、症状积分、氧化应激指标、线粒体融合蛋白等指标水平变化情况。

结果

观察组总疗效率为95.65%（44/46），远高于对照组的76.09%（35/46），组间比较差异有统计学意义（P<0.05）；治疗后观察组收缩压、舒张压、眩晕、头痛、腰膝酸和五心烦热四项症状评分低于对照组（P<0.05）；治疗后观察组谷胱甘肽过氧化物酶（Glutathione peroxidase，GSH-Px）、SOD活性氧（Reactive oxygen species，ROS）高于对照组，丙二醛（Malondialdehyde，MDA）、活性氧（Reactive oxygen species，ROS）低于对照组（P<0.05）；治疗后观察组线粒体融合蛋白1（Recombinant mitofusin 1，MFN1）、线粒体融合蛋白2（Recombinant mitofusin 2，MFN2）、OPA1视神经萎缩蛋白1（Autosomal dominant optic atrophy，ADOA）高于对照组（P<0.05）。

结论

对高血压患者应用天麻钩藤饮治疗可有效改善患者症状，降低其血压水平，通过增强线粒体融合蛋白的表达来延缓血管的衰老，减轻氧化应激反应，提高临床疗效，应用价值较高。

高血压  /  天麻钩藤饮  /  线粒体蛋白  /  氧化应激反应  /  血压水平
Objective

To analyze the therapeutic effect of Tianma Gouteng Yin（天麻钩藤饮）on hypertension and the mechanism of regulating mitochondrial protein pathway.

Methods

Ninety-two patients with hypertension admitted to the hospital from January 2023 to December 2023 were included as study objects，and were divided into two groups by random number table method.Forty-six patients in the control group were treated with nifedipine sustained-release tablet，and the other forty-six patients in the observation group were treated with Tianma Gouteng Yin on this basis.The curative effect，blood pressure level，symptom score，oxidative stress index and mitochondrial fusion protein level were compared between the two groups.

Results

The total curative effect rate of the observation group was 95.65%（44/46），which was much higher than that of the control group（76.09%，35/46），and the difference was significant（P<0.05）.After treatment，the systolic blood pressure，diastolic blood pressure，vertigo，headache，lumbo-knee acid and five upset heat in the observation group were lower than those in the control group（P<0.05）.After treatment，the levels of glutathione peroxidase（GSH-Px）and superoxide dismutase（SOD）in the observation group were higher than those in the control group，the levels of malondialdehyde（MDA）and reactive oxygen species（ROS）were lower than those in the control group（P<0.05）.After treatment，the levels of recombinant mitofusin 1（MFN1），recombinant mitofusin 2（MFN2）and optic nerve atrophy protein 1（OPA1）in the observation group were higher than those in the control group（P<0.05）.

Conclusion

The application of Tianma Gouteng Yin in the treatment of hypertensive patients can effectively improve the symptoms of patients，reduce the level of blood pressure，delay the effect of vascular aging by enhancing the expression of mitochondrial fusion protein，reduce the oxidative stress reaction，improve the clinical efficacy，and has high application value.

hypertension  /  Tianma Gouteng Yin（天麻钩藤饮）  /  mitochondrial protein  /  oxidative stress reaction  /  blood pressure level
潘军伟, 潘铨, 罗晓风. 天麻钩藤饮治疗高血压调控线粒体蛋白通路的机制与疗效研究. 中华中医药学刊, 2025 , 43 (10) : 41 -44 . DOI: 10.13193/j.issn.1673-7717.2025.10.008
Junwei PAN, Quan PAN, Xiaofeng LUO. Study on Mechanism and Effect of Tianma Gouteng Yin（天麻钩藤饮）in Treatment of Mitochondrial Protein Pathway Regulated by Hypertension[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (10) : 41 -44 . DOI: 10.13193/j.issn.1673-7717.2025.10.008
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高血压为临床常见疾病之一，随着病程增加，心、脑、肾等脏器并发症的发生率也随之增加。随着对高血压的深入研究发现，线粒体的正常融合与断裂保证细胞的正常生命活动，而当其发生异常时则会增加氧化应激反应，促进自由基释放，而损伤血管组织，在高血压的发生、发展中起着重要作用[1]。目前临床针对高血压主要以降压药物为主，但部分患者单纯药物治疗血压控制效果不佳，且容易出现不良反应。高血压在中医学中属于“眩晕”“头痛”等范畴，其中阴虚阳亢型是常见证型，平肝潜阳是中医药防治高血压的常用治法之一，有抗炎、调节血压、抗氧化、减弱靶器官损伤的作用[2]。天麻钩藤饮为出自《杂病证治新义》中的经典方剂，有平肝熄火，活血清热之妙用。现代研究认为天麻钩藤饮可调控线粒体蛋白通路，增强其表达而减轻氧化应激反应，为防治高血压起到积极作用[3-4]。鉴于此，本次研究对高血压患者应用天麻钩藤饮治疗，并分析调控线粒体蛋白通路的机制，为临床诊治提供参与依据。现报道如下。
1　临床资料
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1.1　一般资料
纳入2023年1月—2023年12月丽水市中医院中医内科收治的92例高血压患者为研究对象，随机数字表法将其分为两组。纳入标准：1）西医诊断。患者均符合《中国高血压防治指南》[5]中关于高血压的相关诊断标准，在未服用药物的前提下，非同日测量上臂肱动脉部血压3次，患者收缩压≥140 mm Hg和（或）舒张压≥90 mm Hg。2）中医诊断。符合《中药新药临床研究指导原则》[6]中关于高血压的相关标准，辨证分型为阴虚阳亢型，主症为眩晕、头痛、腰膝酸软和五心烦热，次症为心悸、不寐、耳鸣、健忘，舌脉象为舌红少苔、脉弦细而数。排除标准：①肝肾功能存在器质性疾病者；②明确诊断为继发性高血压者；③合并恶性肿瘤者；④因其他原因导致眩晕者；⑤合并自身免疫性疾病者；⑥合并急性脑梗死等急危重症者；⑦合并妊娠期及哺乳期妇女；⑧合并精神疾病者、依从性差者、无法配合研究者。对照组46例，男25例，女21例，年龄49～75岁，平均（53.27±2.75）岁，病程2～8年，平均（4.12±1.21）年，其中高血压分级1级者19例，2级者27例。观察组46例，男24例，女22例，年龄47～76岁，平均（52.85±2.77）岁，病程2～9年，平均（4.14±1.25）年，其中高血压分级1级者21例，2级者25例。两组患者上述资料比较差异无统计学意义（P>0.05），可比性较好。本研究经伦理委员会审批通过，患者均签署同意书以表知情。
1.2　方法
1.2.1　对照组
采用硝苯地平缓释片治疗。给予陕西步长高新制药有限公司所生产的硝苯地平缓释片（国药准字H61023583，规格10 mg）口服，20 mg/次，1次/d；同时嘱咐患者低钠低脂饮食，适当运动，注意休息。
1.2.2　观察组
在上述基础上予以天麻钩藤饮治疗，药用：天麻12 g，钩藤15 g，石决明20 g，栀子6 g，黄芩6 g，川牛膝15 g，杜仲12 g，益母草10 g，桑寄生12 g，夜交藤12 g，朱茯神9 g。若患者存在头痛、眩晕情况，则加牡蛎和羚羊角各9 g，龙骨6 g；阴虚较甚者加生地黄12 g，麦冬12 g。将上述中药以水煎煮至250 mL，1剂/d，分早晚服用。两组持续治疗3个月。
1.3　观察指标
①疗效评估：经过治疗后患者眩晕、头痛等症状显著缓解，血压恢复正常或舒张压降低≥20 mm Hg，则为治疗显效；经过治疗后患者相关症状有所减轻，收缩压降低≥30 mm Hg或舒张压降低超过10 mm Hg，≤19 mm Hg，未达理想范围，则为治疗有效；经过治疗后患者相关临床症状未见改善，血压下降未达上述标准甚至增高，则为治疗无效。治疗总有效率＝（显效+有效）例数/总例数×100%；②血压水平：观察两组治疗前及治疗后3个月血压水平变化情况；③症状评分：本次研究对两组“眩晕”“头痛”“腰膝酸软”和“五心烦热”4项主症进行重点观察，依据其严重程度分别计0～4分，依次表示无（-）、轻（+）、中度（++）和重度（+++）；④氧化应激指标：于治疗前后采集患者空腹肘静脉血10 mL，3000 r/min离心处理，半径10 cm，时间15 min，获得血清后采用ELISA法检测血清丙二醛（Malondialdehyde，MDA）、超氧化物歧化酶（Superoxide dismutase，SOD）、谷胱甘肽过氧化物酶（Glutathione peroxidase，GSH-Px）、血清活性氧（Reactive oxygen species，ROS），观察其水平变化情况；⑤线粒体融合蛋白：于治疗前后采集患者肘静脉血3 mL，离心处理后采用ELISA检测线粒体融合蛋白1（Recombinant mitofusin 1，MFN1）、线粒体融合蛋白2（Recombinant mitofusin 2，MFN2）、视神经萎缩蛋白1（Autosomal dominant optic atrophy，ADOA），观察其变化情况。
1.4　统计学方法
采用SPSS 22.0软件统计分析处理数据。连续变量若符合正态分布和方差同质性，以均值±标准差（）呈现，不同组间血压水平、症状评分、氧化应激、线粒体融合蛋白比较使用独立样本t检验，同组内血压水平、症状评分、氧化应激、线粒体融合蛋白比较使用配对t检验；分类变量以比例或百分比表示，组间差异采用χ2检验分析。统计学显著性水平定为P<0.05。
2　结果
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2.1　治疗效果比较
观察组总疗效率为95.65%，远高于对照组的76.09%，组间比较差异有统计学意义（P<0.05）。见表1。
2.2　血压水平比较
治疗前两组收缩压、舒张压水平比较差异无统计学意义（P>0.05）。治疗后两组收缩压、舒张压水平均有降低（P<0.05），且相较于对照组，观察组血压水平降低幅度更大，组间差异有统计学意义（P<0.05）。见表2。
2.3　症状积分水平比较
治疗前两组眩晕、头痛、腰膝酸和五心烦热四项症状评分比较差异无统计学意义（P>0.05）；治疗后两组上述评分均有所降低（P<0.05），且相较于对照组，观察组分值水平降低幅度更大，组间差异有统计学意义（P<0.05）。见表3。
2.4　应激反应指标水平比较
治疗前两组MDA、GSH-Px、SOD、ROS水平比较差异无统计学意义（P>0.05）；治疗后观察组GSH-Px、SOD高于对照组，MDA、ROS低于对照组，组间比较差异有统计学意义（P<0.05）。见表4。
2.5　线粒体融合蛋白相关指标比较
治疗前两组患者血清MFN1、MFN2、OPA1水平比较差异无统计学意义（P>0.05）；治疗后两组上述3项指标水平均有所升高（P<0.05），且与对照组比较，观察组升高更为明显（P<0.05）。见表5。
3　讨论
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中医学认为该病属于本虚标实，上盛下虚之证，将其归属于“眩晕”“头痛”“不寐”等范畴，与患者肝肾阴阳失调、肝阳上亢存在密切关系[7]。本病患者多为中老年人，存在素体虚弱、机体逐渐衰退、年老体衰的特点，其肾精逐渐亏虚，肾阴不足，水不涵木，肝失所养，而引起肝阳化风，肝风内眩，风阳升动而作眩[8-9]。加上先天禀赋不足、情志失调和饮食失节等因素，加剧肝肾阴阳失调，易形成阴虚阳亢体质和引起眩晕、不寐和头痛等症状[10-11]。如《素问·至真要大论篇》记载“诸风掉眩，皆属于肝”，也指出肝阳上亢是眩晕的密切关系[12]。因此针对高血压患者应采取滋补肝肾、平肝潜阳，以调节脏腑阴阳平衡为主。
天麻钩藤饮为平肝降逆之剂，出自中医家胡光慈的《杂病证治新义》[13]。本次研究在常规西药治疗基础上应用天麻钩藤饮治疗，结果发现治疗后观察组收缩压、舒张压水平均低于对照组，且治疗后眩晕、头痛、腰膝酸软和五心烦热四项症状评分也低于对照组，可见应用天麻钩藤饮治疗高血压可有效改善患者眩晕、头痛等相关症状，降低其血压水平。这是由于天麻钩藤饮方中天麻、钩藤为君药，其中天麻归于肝经，有祛风通络、平抑肝阳、息风止痉的功效[14]；钩藤归于肝经与心包经，有定惊平肝、清热息风的作用[15]；石决明性寒，归为肝经，为平肝潜阳重镇之要药，有清肝明目的作用，可助力君药平肝息风[16]；川牛膝归于肝经、肾经，有补肝益肾，强筋健骨，逐瘀通经的作用，可引血下行，活血利水[17]；杜仲、桑寄生补肝益肾、祛风除湿[18]；栀子、黄芩有清热燥湿、泻火除烦的作用[19]；益母草归为肝、心包经，具有活血、利水、清热解毒的作用，与川牛膝合用有利于平降肝阳[20]；夜交藤、朱茯神归为心、肝经，有宁心安神的功效[21]；诸药合用共奏补肝益肾、平肝息风、活血利水、调节脏腑阴阳平衡的功效。
目前研究发现高血压的发生发展与线粒体、氧化应激存在密切联系。MDA、GSH-Px、SOD、ROS为常见的氧化应激指标，其中ROS水平可升高，使得ROS的产生与清除体系失衡，而过量的ROS会使细胞组织不同程度氧化损伤，促进血管衰老的发展[22-23]。动物研究也表明，自发性高血压病模型大鼠诱导血管衰老过程中，血管组织线粒体呼吸链复合物Ⅲ和氧化损伤产物MDA水平明显增高，而SOD活性降低，抗氧化防御系统清除ROS的能力也大大降低[24-25]。而线粒体是ROS生成的重要来源，线粒体功能障碍也是机体衰老的重要标志。研究表明，与年轻者相比，高血压患者血管中线粒体总量、线粒体DNA含量、线粒体生成蛋白水平等均偏低[26-27]。MFN1、MFN2、OPA1属于线粒体融合蛋白，其水平升高表明线粒体功能良好，或受损线粒体的功能得到修复。本次研究中，观察组MFN1、MFN2、OPA1高于对照组，氧化应激指标GSH-Px、SOD高于对照组，MDA、ROS低于对照组，可见应用天麻钩藤饮治疗高血压患者能调控线粒体相关蛋白MFN1、MFN2、OPA1的表达，从而改善氧化应激反应，延缓血管衰老，而控制患者血压水平。分析原因可能是由于天麻钩藤饮中天麻经现代药理研究表明，能激活交感神经兴奋性，促进内皮素与血管紧张素的分泌，可馈赠微血管与小动脉[28]；钩藤中主要成分如皂苷类、黄酮类、生物碱等可抑制RASS系统作用，提高血清中一氧化氮含量，对血管平滑肌增殖起到抑制；石决明中碳酸钙等主要成分可增加细胞膜的稳定，促进内皮细胞功能的改善[29]；杜仲有保肝、延缓衰老的作用；栀子中西红花苷可抑制胰脂酶的产生，调节血脂，预防动脉粥样硬化等[30-31]。故将其用于高血压防治提供新方向。
综上所述，对高血压患者应用天麻钩藤饮治疗可有效改善患者症状，降低其血压水平，通过增强线粒体融合蛋白的表达来延缓血管衰老的作用，减轻氧化应激反应，提高临床疗效，应用价值较高。
基金
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  • 国家重点研发计划“中医药现代化”重点专项(2019YFC1712500)
  • 浙江省中医药科研基金项目(2021ZB341)
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2025年第43卷第10期
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doi: 10.13193/j.issn.1673-7717.2025.10.008
  • 首发时间：2026-10-30
  • 出版时间：2025-10-10
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国家重点研发计划“中医药现代化”重点专项(2019YFC1712500)
浙江省中医药科研基金项目(2021ZB341)
作者信息
    丽水市中医院，浙江 丽水 323000

通讯作者:

潘铨（1980-），男，安徽黄山人，主任中医师，硕士，研究方向：中医药防治心血管疾病。E-mail：。
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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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