目的 研究替米沙坦联合羟苯磺酸钙对高血压合并2型糖尿病血压节律的影响。 方法 选取2021年1月至2022年12月在衡水市人民医院诊治的高血压合并2型糖尿病患者作为研究对象，按照随机分组原则将患者分为对照组（n = 115）和观察组（n = 113）。对照组患者给予替米沙坦治疗（每天1次，每次40 mg），观察组患者在对照组患者治疗的基础上额外给予羟苯磺酸钙治疗（每天3次，每次0.5 g）。两组患者均治疗12个月，每3个月进行1次随访。统计两组患者治疗前后的血压指标水平，包括24 h平均收缩压（24 h SBP）、24 h平均舒张压（24 h DBP）、24 h平均脉压差（24 h PP）、白昼平均收缩压（dSBP）、白昼平均舒张压（dDBP）、白昼平均脉压差（dPP）、夜间平均收缩压（nSBP）、夜间平均舒张压（nDBP）、夜间平均脉压差（nPP）；血糖指标水平，包括空腹血糖（FBG）、餐后2 h 血糖（2 h PG）、糖化血红蛋白（HBA1c）；血管内皮功能指标水平，包括内皮素-1（ET-1）、一氧化氮（NO）、血管内皮生长因子（VEGF）和用药期间不良反应发生情况。 结果 治疗前，两组患者的各项指标水平（血压、血糖、血管内皮功能）经比较差异无统计学意义（P > 0.05）。治疗3、6、12个月后，两组患者血压指标水平（24 h SBP、24 h DBP、24 h PP、dSBP、dDBP、dPP、nSBP、nDBP、nPP）、血糖指标水平（FBG、2 h PG、HBA1c）和血管内皮功能指标水平（ET-1）均显著低于治疗前，且观察组患者上述指标水平均低于对照组，差异有统计学意义（P < 0.05）。而两组患者的NO和VEGF水平在治疗后均显著高于治疗前，且观察组患者的NO和VEGF水平均高于对照组，差异有统计学意义（P < 0.05）。在用药期间两组患者不良反应发生率经比较差异无统计学意义（P > 0.05）。 结论 替米沙坦联合羟苯磺酸钙可有效降低高血压合并2型糖尿病患者血压水平，调节血压节律，改善血管内皮功能，且安全性良好。

Objective To explore the effect of telmisartan combined with calcium dobesilate on hypertensive patients with type 2 diabetes mellitus （T2DM） on the blood pressure rhythm. Methods Patients with hypertension and T2DM who were treated in Hengshui people′s Hospital from January 2021 to December 2022 were selected as the study subjects. According to the principle of random grouping， the patients were divided into the control group （n = 115） and the observation group （n = 113）. Patients in the control group were treated with telmisartan （40 mg once daily）， while the patients in the observation group received additional calcium dobesilate treatment （0.5 g three times daily） on the basis of the treatment in the control group. Both groups of patients were treated for 12 months with follow-up visits every 3 months. The blood pressure indicators including 24-hour average systolic blood pressure （24 h SBP）， 24-hour average diastolic blood pressure （24 h DBP）， 24-hour average pulse pressure （24 h PP）， daytime average systolic blood pressure （dSBP）， daytime average diastolic blood pressure （dDBP）， daytime average pulse pressure （dPP）， nighttime average systolic blood pressure （nSBP）， nighttime average diastolic blood pressure （nDBP） and nighttime average pulse pressure （nPP）； blood glucose indicators including fasting blood glucose （FBG）， 2-hour postprandial blood glucose （2 h PG） and glycosylated hemoglobin （HBA1c）； endothelial function indicators including endothelin-1 （ET-1）， nitric oxide （NO） and vascular endothelial growth factor （VEGF）； and occurrence of adverse reactions during the medication period were statistically analyzed for both groups of patients. Results Before treatment， there were no statistically significant differences （P > 0.05） in the various indicators （blood pressure， blood glucose， endothelial function） between the two groups of patients. After 3， 6， and 12 months of treatment， the blood pressure indicators （24 h SBP， 24 h DBP， 24 h PP， dSBP， dDBP， dPP， nSBP， nDBP， nPP）， blood glucose indicators （FBG， 2 hPG， HBA1c）， and endothelial function indicators （ET-1） were significantly lower than before treatment in both groups of patients， and the levels of these above-mentioned indicators in the observation group were lower than those in the control group， with statistically significant differences （P < 0.05）. The levels of NO and VEGF in both groups of patients were significantly higher than before treatment， and the levels of NO and VEGF in the observation group were higher than those in the control group， with statistically significant differences （P < 0.05）. The incidence of adverse reactions during the medication period showed no statistically significant differences between the two groups of patients （P > 0.05）. Conclusion The combination of telmisartan combined with calcium dobesilate reduces blood pressure levels， regulates blood pressure rhythm， and improves endothelial function in patients with hypertension and T2DM， and shows favorable safety.