The Treatment Of Menopausal Women With Essential Hypertension Qingxuan Buck Soup Clinical Studies

Hypertension is a serious frequent and common disease,which influence human health and quality of life.It was one of the most risk factors of coronary heart disease,stroke and renal failure.According to the 2002 residents of nutrition & health survey,adult hypertension morbidity rate is 18.8%in our country,the national patients of hypertension already reach 1.6 hundred millions.But the awareness,treatment,and control of hypertension were very limited, to seek safe and effective drugs is the main task for preventing and treating hypertension.Recently epidemiological studies showed that women hypertension have less prevalence than men before menopausal,but more after menopausal.Menopause is a special period in women with functional disorder of nerve-endocrine dysfunction,the patients' blood pressure in this period is not very high,but large fluctuations.They often have the symptoms which influence the quality of life seriously such as mood irritability,easily agitated,insomnia and so on.Research shows that syndrome of deficiency of liver-kidney yin,hyperactivity of liver yang is not only the major syndrome of hypertension,but also in menopausal women hypertension.Qingxuanjiangya Decoction is founded by Keji Chen academician according to his decades of clinical experience.Consider to the pathogenesis of hypertension characteristics,it is an effective decoction with the effects of nourishing the liver and kidney,clearing the liver heat,calming and suppressing liver yang,which can treat the hypertension of deficiency of liver-kidney yin,hyperactivity of liver yang syndrome.This study is emphasis on researching the clinical effects of Qingxuanjiangya Decoction on menopausal women hypertension patients.Objective:to observe the effect of decreasing blood pressure of Qingxuanjiangya Decoction on menopausal women hypertension patients,and to observe its effect in the aspects of symptoms,24h ambulatory blood pressure,heart rate,glucose and lipid metabolism, E₂,Hs-CRP,HCY and Angâ…¡,to find out the antihypertension mechanism and clinical effects, to further the treatment of integrated traditional Chinese and western medicine on menopausal women. Method:This was a randomized controlled clinical trial.88 cases enrolled and 82 cases finished.The patients were randomized into 2 groups:the control group(n=40):perindopril tablets(4mg,QD)+simulation,the test group(n=42):perindopril tablets+Qingxuanjiangya Decoction.The treatment last for 2 months,the changes of their symptoms,ambulatory blood pressure,heart rate,blood sugar,blood lipids,E₂,Hs—CRP,HCY and Angâ…¡were observed.Result:1.The effects on blood pressure:Perindopril tablets + simulation group(control group), Perindopril + Qingxuanjiangya Decoction group(test group) the total efficiency were 87.5%,90.4%respectively,obvious effective rate in control group was 45%while 59.6%in test group.2.The effects on ambulatory blood pressure:Test group was better than control group in 24h,daytime,nighttime blood pressure variability and nighttime blood pressure drop rate,the difference being significant(P＜0.05);but there was no different in 24h,daytime and nighttime average SBP,DBP,MAP,24h systolic and diastolic blood pressure load.3.The effect on heart rate:After treatment both groups of heart rate decreased than before with significant differences(P＜0.05),test group was better than control group,the difference being significant(P＜0.05).4.The effect on symptoms:Test group and control group the total efficiency were 87.5%,90.5%respectively,obvious effective rate in control group was 55%while 62%in test group;on the aspect of symptom score decreased,test group was significantly better than control group,the difference being significant(P＜0.05);especially in the symptoms of headache,soreness and weakness of waist and knees and insomnia.5.The effect on blood glucose:there is certain decreased in blood glucose of both groups after treatment,but this decrease was not significant.6.The effect on serum lipids:Test group was better than control group in reducing the level of TC,LDL,the difference being significant(P＜0.05).7.The effect on E₂:Test group was better than control group in increasing the level of E₂, the difference being significant(P＜0.05). 8.The effects on the level of Hs—CRP,HCY,Angâ…¡:Test group was better than control group in decreasing the level of Hs—CRP,Angâ…¡,the difference being significant(P＜0.05); but there was no different in HCY(P＞0.05).Conclusion:1.Qingxuanjiangya Decoction can reduce the blood pressure variability of menopausal women hypertension,increase nighttime blood pressure drop rate,improve the blood pressure to normal rhythm,and improve the clinic symptoms and decrease heart rate significantly, which were superior to use western medicine only.These effects maybe related to regulating the function of sympathetic-vagus nerve.2.Qingxuanjiangya Decoction can improve blood lipid metabolism,decrease the level of TC,LDL,Hs—CRP,and increase the level of plasma endogenous estrogen in menopausal women,improve the symptoms of menopause syndrome,these effects maybe related to regulating the nerve-endocrine-immune systerm,which can recover the hypothalamus-pituitary systerm feedback and adjust the secretion of sex hormones and neurotransmitter.3.Qingxuanjiangya Decoction can improve the level of plasma and Angâ…¡in menopausal women,its antihypertension mechanism maybe related to inhibit the activity of RAAS.4.During the 2-month study,Qingxuanjiangya Decoction had no obvious toxicity and side effect in patients.