目的比较奥美沙坦酯联合氨氯地平与奥美沙坦酯联合氢氯噻嗪在治疗原发性高血压中的降压疗效。方法 80例原发性高血压患者随机分为奥美沙坦-氨氯地平组和奥美沙坦-氢氯噻嗪组,每组40例。奥美沙坦-氨氯地平组给予奥美沙坦酯20 mg和氨氯地平5 mg,口服,qd;奥美沙坦-氢氯噻嗪组给予奥美沙坦酯20 mg和氢氯噻嗪12.5 mg,口服,qd;疗程均为8周。观察患者24 h动态血压变化情况、血压昼夜波动节律,检测治疗前后实验室指标并记录不良反应发生情况。结果两组患者治疗后白昼、夜间平均收缩压和舒张压均降低(P<0.05),两组降低幅度无显著差异(P>0.05)。奥美沙坦-氨氯地平组治疗后白昼、夜间收缩压和舒张压变异均低于奥美沙坦-氢氯噻嗪组(P<0.05)。奥美沙坦-氨氯地平组血压昼夜节律异常逆转率为79%(11/14),高于奥美沙坦-氢氯噻嗪组(25%,4/16,P<0.05)。两组实验室指标均无明显变化。两组均无明显不良反应发生。结论奥美沙坦酯联合氨氯地平与奥美沙坦酯联合氢氯噻嗪治疗原发性高血压的降压效果相当,但前者在降低血压变异性、改善高血压患者血压昼夜节律变化方面效果更佳,具有平稳降压的作用。 Objective To compare the antihypertensive effect of olmesartan medoxomil combined with amlodipine and olmesartan medoxomil combined with hydrochlorothiazide in the treatment of essential hypertension. Methods Eighty patients with essential hypertension were randomly divided into olmesartan - amlodipine group and olmesartan - hydrochlorothiazide group, 40 cases in each group. Olmesartan - amlodipine group were given olmesartan medoxomil 20 mg and amlodipine 5 mg orally, qd; olmesartan - hydrochlorothiazide group were given olmesartan medoxomil 20 mg and hydrochlorothiazide 12.5 mg, oral, qd; For 8 weeks. Observed 24 h ambulatory blood pressure changes, circadian rhythm of blood pressure, laboratory tests before and after treatment indicators and record the incidence of adverse reactions. Results After treatment, the average systolic and diastolic blood pressure decreased in both groups during the day and night (P <0.05). There was no significant difference between the two groups (P> 0.05). In the olmesartan-amilodipine group, the variations of systolic and diastolic blood pressure during the day and night were lower than those of the olmesartan-hydrochlorothiazide group (P <0.05). The reversal rate of abnormal circadian rhythm of blood pressure in the olmesartan-amilodipine group was 79% (11/14), higher than that in the olmesartan-hydrochlorothiazide group (25%, 4/16, P <0.05). No significant changes in the two laboratory indicators. No significant adverse reactions occurred in both groups. Conclusions Olmesartan medoxomil combined with amlodipine combined with olmesartan medoxomil and hydrochlorothiazide is effective in reducing hypertension in patients with essential hypertension. However, the former is more effective in lowering blood pressure variability and improving the circadian rhythm of blood pressure in patients with hypertension. Smooth buck effect.