目的:观察不同服药时间对高血压病患者血压控制的效果。方法:选择2级高血压病患者60例,随机分为观察组和对照组各30例。两组均采用替米沙坦片及硝苯地平控释片治疗。观察组采用晨起服用替米沙坦片,睡前服用硝苯地平控释片;对照组采用晨起服药替米沙坦片和硝苯地平控释片。治疗后3个月、6个月,进行24h动态血压监测,观察比较两组日间血压、清晨血压及血压昼夜节律变化。结果:(1)治疗后,两组24h平均收缩压(TSBP)和舒张压(TDBP)、日间平均收缩压(DSBP)和舒张压(DDBP)、夜间平均收缩压(NSBP)和舒张压(NDBP),均较治疗前非常显著下降(P<0.01),但观察组NSBP和NDBP较对照组下降更显著(P<0.05)。(2)治疗后,两组血压均值均显著下降,但观察组较对照组下降更显著(P<0.05)。(3)治疗后,两组清晨血压均有下降,但观察组比对照组下降显著(P<0.05)。(4)治疗后,两组血压节律均有恢复,但观察组杓型血压恢复较对照组更显著(P<0.05)。结论:采用晨起及睡前给药方式,可有效降低24h血压,更好地纠正清晨高负荷血压,提高清晨血压达标率,恢复血压正常昼夜节律。 Objective: To observe the effect of different medication time on blood pressure control in patients with essential hypertension. Methods: Sixty patients with grade 2 hypertension were randomly divided into observation group and control group with 30 cases each. Both groups were treated with telmisartan tablets and nifedipine controlled release tablets. The observation group was treated with telmisartan tablets in the early morning and nifedipine controlled-release tablets at bedtime. The control group was treated with telmisartan tablets and nifedipine tablets in the morning. Three months after treatment, 6 months, 24h ambulatory blood pressure monitoring, observing and comparing two groups of daytime blood pressure, morning blood pressure and blood pressure circadian rhythm changes. Results After treatment, the mean systolic blood pressure (TSBP) and diastolic blood pressure (TDBP), the mean systolic blood pressure (DSBP) and diastolic blood pressure (DDBP), the mean systolic blood pressure at night (NSBP) and the diastolic blood pressure NDBP) were significantly lower than those before treatment (P <0.01), but the NSBP and NDBP in the observation group decreased more significantly than those in the control group (P <0.05). (2) After treatment, mean blood pressure decreased significantly in both groups, but the observation group decreased more significantly than the control group (P <0.05). (3) After treatment, the blood pressure decreased in both groups in the early morning, but the observation group decreased significantly (P <0.05) compared with the control group. (4) After treatment, the blood pressure rhythm was recovered in both groups, but the dipper blood pressure recovery in the observation group was more significant than that in the control group (P <0.05). Conclusion: Early morning and bedtime administration can effectively reduce blood pressure 24 hours, to better correct early morning high blood pressure, improve early morning blood pressure compliance rate and restore normal blood pressure circadian rhythm.