目的 探討山綠茶降壓片聯(lián)合馬來酸依那普利葉酸片治療H型原發(fā)性高血壓的臨床療效。方法 選取2016年9月-2017年9月在濮陽市安陽地區(qū)醫(yī)院進(jìn)行治療的H型原發(fā)性高血壓患者84例，隨機(jī)分為對(duì)照組（42例）和治療組（42例）。對(duì)照組口服馬來酸依那普利葉酸片，1片/次，1次/d；治療組在對(duì)照組的基礎(chǔ)上口服山綠茶降壓片，4片/次，3次/d。兩組均治療4周。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者血壓變化情況、血清細(xì)胞因子水平和血管內(nèi)皮功能指標(biāo)。結(jié)果 治療后，對(duì)照組臨床有效率為80.95%，顯著低于治療組的95.24%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者24 h平均收縮壓（mSBP）、24 h平均舒張壓（mDBP）均明顯低于降低（P<0.05），且治療組患者血壓明顯優(yōu)于對(duì)照組（P<0.05）。治療后，兩組患者血清超敏C反應(yīng)蛋白（hs-CRP）、同型半胱氨酸（Hcy）、單核細(xì)胞趨化蛋白-1（MCP-1）、基質(zhì)金屬蛋白酶-9（MMP-9）水平顯著降低（P<0.05），且治療后治療組血清細(xì)胞因子水平明顯低于對(duì)照組（P<0.05）。治療后，兩組血清一氧化氮（NO）水平顯著升高（P<0.05），內(nèi)皮素（ET）水平顯著降低（P<0.05），且治療組血管內(nèi)皮功能明顯好于對(duì)照組（P<0.05）。結(jié)論 山綠茶降壓片聯(lián)合馬來酸依那普利葉酸片治療H型原發(fā)性高血壓可有效降低血壓，降低血清Hcy，改善血管內(nèi)皮功能，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To explore the clinical effect of Shanlvcha Jiangya Tablets combined with enalapril and folic acid in treatment of H-type hypertension. Methods Patients (84 cases) with H-type hypertension in Anyang District Hospital from September 2016 to September 2017 were randomly divided into control (42 cases) and treatment (42 cases) groups. Patients in the control group were po administered with Enalapril Maleate and Folic Acid Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Shanlvcha Jiangya Tablets on the basis of the control group, 4 tablets/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the change of blood pressure, the serum cytokine levels, the vascular endothelial function indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 80.95%, which was significantly lower than 95.24% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the 24 h mSBP and 24 h mDBP in two groups was significantly decreased (P<0.05), and the blood pressure in the treatment group after treatment was significantly better than that in the control group (P<0.05). After treatment, the hs-CRP, Hcy, MCP-1 and MMP-9 levels in two groups were significantly decreased (P<0.05), and the serum cytokine levels in the treatment group after treatment were significantly lower than those in the control group (P<0.05). After treatment, the NO levels in two groups were significantly increased (P<0.05), but the ET-1 levels were significantly decreased (P<0.05), and the vascular endothelial function in the treatment group after treatment was significantly better than that in the control group (P<0.05). Conclusion Shanlvcha Jiangya Tablets combined with enalapril and folic acid in treatment of H-type hypertension can effectively reduce blood pressure and serum Hcy levels, and improve vascular endothelial function, which has a certain clinical application value.