Objective To analyze the present situation of individual treatment plan in treating hypertension with small doses of combined drugs including nifedipine ( N ), atenolol ( A ), hydrochlorothiazide ( H ) and captopril ( C ) after four years of its spread in grass roots, Xining. To evaluate the feasibility of the plan and the existing problems. Methods Select all the medical records of hypertension patients treated by NAHC individual treatment therapy in Xining from January 1, 2006 to December 31, 2009 to summarize and analyze this method from the aspects of its technical training, drugs selection, joins procedure, method of taking drugs, treatment costs and blood pressure of the patients before treatment, the blood pressure after treatment, the situation of continual medicine - taking, the reason of withdrawal from the therapeutic schedule and so on. Results A total of 801 patients were included with average age ( 57. 3 ± 10. 3 ), 340 males and 433 females. Before treatment, the average systolic blood pressure ( SBP ): ( 147. 9 ± 19. 4 ) mm Hg, the average diastolic blood pressure ( DBP ): ( 91. 4 ± 14. 1 ) mm Hg; After treatment, 368 subjects have records of blood pressure, the male are 160 cases and female 280 cases. The average SBP: ( 128. 5 ± 12. 4 ) mm Hg, the average DBP: ( 80. 05 ±8. 7 ) mm Hg. 351 patients' hypertension were recovered; the total effective rate was 95. 4% ; 85 cases had kept on taking medicine for 2 years or more, accounting for 10. 6% . Because the medical records are not complete, the numbers of no sex record, no contact phone number, no blood pressure record before treatment, no age record, no previous highest blood pressure record or family history were respectively 28, 29, 33, 34, 365 and 392. The average expense of daily use on drugs was 0. 09 yuan, and annual cost was 33 yuan. Conclusion The cost of NAHC indi-viduation therapeutic schedule is inexpensive with sound therapeutic effects and is fit to be popularized in the grass roots. But the actual implementing effect was poor, so long - term stable executable scheme is needed and more policy and financial tilting support should be provided for the project so as to guarantee a breakthrough in high blood pressure control work in grass roots in China.%目的 通过对西宁市基层推广小剂量硝苯地平(N)、阿替洛尔(A)、氢氯噻嗪(H)、卡托普利(C)联合治疗高血压个体化方案实施4年的情况进行分析,探讨该方案在基层推广的可行性及存在问题.方法 选取西宁市2006-2009年所有行NAHC个体化治疗的高血压患者的病历资料,从该方案的技术培训、药品选择、加入程序、服药方法、治疗费用和患者治疗前血压、治疗后血压、续服药情况及退出治疗方案原因等方面进行总结分析.结果 共纳入801例患者,男340例,女433例,平均年龄(57.3±10.3)岁.治疗前平均收缩压(SBP)(147.9±19.4)mm Hg(1 mm Hg=0.133 kPa),平均舒张压(DBP)(91.4±14.1)mm Hg;治疗后有血压测量记录者368例,其中男160例,女280例,平均SBP(128.5±12.4)mm Hg,平均DBP(80.1±8.7)mm Hg.治疗达标351例,达标率95.4%;坚持服药2年及以上者85例,占10.6%.因资料不全,出现无性别、无联系电话、无治疗前血压、无年龄、无既往最高血压、无家族史者,分别为28、29、33、34、365和392例.服药日均费用0.090元,年费用33元.结论 NAHC个体化治疗方案费用低廉,疗效确切,适合基层推广.但实际实施效果差,需制订长期稳定的可执行方案及对该项目的 政策和资金倾斜,为真正实现我国基层高血压防治工作的实质性突破提供保障.
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