Clinical Observation Of Treatment Of Integrated Chinese And Western Medicine On Hypertension And Early Renal Damage Of The Elder Hypertensives With Syndrome Of Phlegm-stasis Blocking Collaterals

Objective:To analyze the difference between integrated Chinese and Western medicine group and Western medicine group on antihypertensive effect,improving early renal damage in elderly hypertension patients with phlegm and blood-stasis blocking collaterals syndrome,so as to provide clinical evidence for differentiation and treatment of TCM on elderly hypertension patients.Methods:With the methods of computer randomized,positive medicine controlled,in the areas of Jingzhuang country Yanqing county of Beijing,Changping district hospital of TCM,Huaiyin district of Jinan city,Shandong province,we collected 90 elder patients with hypertension of phlegm and blood stagnation and randomly assigned them to two groups,45 in the integrated Chinese and western medicine group, and another 45 cases in western medicine group, and separately treated them with jiangya I combined with western medicine or only with western medicine. Clinical blood pressure and 24hours ambulatory blood pressure moniter were measured, and kept the urine and blood specimen before and after treatment,testing the five indexes (MALB, TRF,NAG, beta 2-MG,IgG) of renal damage, and cyst-c level in the blood serum. Meanwhile analyzing their drug safety. The course of treatment was 6 months.Results:After the treatment of integrated traditional Chinese and western medicine group withdrawed 4 cases,and western medicine group 5 cases. As to clinic blood pressure before and after the treatment compared, systolic blood pressure of two groups were both significantly lowered, which had statistically significance (P<0.05);compared between the two groups,after treatment both the level of systolic blood pressure and the difference between before and after treatment in integrated traditional Chinese and western medicine group were better than those in western medicine group (P<0.05);while the diastolic blood pressure comparison had no statistical difference(P>0.05).24-hour ambulatory blood pressure parameters comparison, the average level of SBP during the day,night and 24h all decreased in both groups,and had statistical significance(P<0.05), while the diastolic pressure compared before and after the treatment was not statistically significant (P>0.05). Comparison between groups, two groups of 24-hour ambulatory blood pressure parameters had no significant differences (P>0.05), and comparisons of blood pressure load was also not statistically significant (P>0.05).On the aspects of improving early renal damage,the five items of renal damage were significantly lower than before treatment in integrated traditional Chinese and western medicine group (P<0.05),including trace albumin with a statistically significance (P<0.01); in Western medicine treatment group,items of MALB, IGU and beta 2-MG were lower than before treatment(P<0.05), while the items of NAG and TRF were not statistically significant compared before and after the treatment (P>0.05). Comparison between groups,the urine MALB and NAG level in integrated traditional Chinese and western medicine group were obviously better than those in western medicine group (P<0.05), and the rest had no significant differences(P>0.05). Serum cystatin C level had no significant difference not only in before and after the treatment compared in the two groups,but also in comparison between the two groups (P>0.05). And there was no abnormal changes in urine and blood routine, liver and kidney function as well as electrocardiogram.Conclusion:The integrated traditional Chinese and western medicine group was superior to western medicine group in decreasing the systolic blood pressure level,improving early renal damage,and had lower adverse reaction,which indicated its safety and effectiveness.