Clinical Study Of Liuwei Dihuang Wan Combined With Danzhi Xiaoyao San To H-type Hypertension With Syndrome Of Yin Deficiency And Yang Hyperactivity

H-type hypertension is a special type of hypertension,in which"H"mainly refers to homocysteine(Hcy).Blood Hcy≥10μmol·L-1 is usually defined as H-type hypertension.The syndrome of Yin deficiency and Yang hyperactivity is a common type of hypertension syndrome in traditional Chinese medicine,which has a certain influence on the prognosis of patients.If not treated scientifically,it is not conducive to the health of patients.Liuwei Dihuang Wan and Danzi Xiaoyao San are common medicinal materials in traditional Chinese medicine.The combined application of Liuwei Dihuang Wan and Danzi Xiaoyao San can nourish Yin and tonify kidney and relieve qi and relieve depression,at the same time,it can obviously reduce blood pressure and other clinical symptoms of patients.Based on the analysis of the clinical situation of Liuwei Dihuang Wan combined with Danzi Xiaoyao San in the treatment of H-type hypertension syndrome of Yin deficiency and Yang hyperactivity,the therapeutic effect and related mechanism of this combination of drugs on patients were explored.Objective:To discuss effect of Liuwei Dihuang Wan combined with Danzi Xiaoyao San to H-type hypertension with syndrome of Yin Deficiency and Yang Hyperactivity and to study influence to vascular endothelial function and inflammatory factors.Methods:One hundred and fifty patients were randomly divided into control group 75cases and observation group 75 cases by random number table.Patients in control group got enalapril maleate and folic acid tablets,10 mg/0.8 mg/time,1 time/day,and patients whose blood pressure couldn’t be controlled added extended release nifedipine tablets,20-30 mg/time,2 times/days.Based on the treatment in control group,patients in observation group added addition and subtraction therapy of Liuwei Dihuang Wan combined with Danzi Xiaoyao San,1 dose/day.The course of treatment was 12 weeks.Before and after treatment,systolic blood pressure(SBP),diastolic blood pressure(DBP)and achievement of blood pressure were detected.And ambulatory blood pressure,standard deviation of 24-hours systolic blood pressure(24h SSD),standard deviation of24-hours diastolic blood pressure(24h DSD),24 h mean systolic blood pressure(24h SBP),24 h mean diastolic blood pressure(24h DBP)were recorded.And ankle brachial index(ABI)and brachial artery blood flow-mediated diameter(FMD)were discussed,scores of syndrome of Yin Deficiency and Yang Hyperactivity were graded,and levels of interleukin-6(IL-6),interleukin-10(IL-10),high-sensitivity C-reactive protein(hsCRP)and homocysteine(Hcy)were detected.Results:Rank sum test was used to analyze the effect of blood pressure,the observation group was better than the control group(Z=2.054,P<0.05);the observation group was better than the control group in the effect of TCM syndromes(Z=2.611,P<0.01);In observation group,levels of SBP,DBP,24h SSD,24h DSD,24h SBP and 24h DBP were all lower than those in control group(P<0.01).Achievement rate of accidental blood pressure in observation group was 81.19%,higher than 66.98%in control group(?~2=29.81,P<0.01).And levels of ABI,FMD and IL-10 were higher than those in control group(P<0.01),score of syndrome of Yin Deficiency and Yang Hyperactivity and levels of Hcy,leptin,IL-6 and hs-CRP were lower than those in control group(P<0.01).Conclusion:On the basic treatment of antihypertensive and folic acid supplementation,Liuwei Dihuang Wan combined with Danzi Xiaoyao San can control the level of blood pressure and Hcy,alleviate the variability of blood pressure,raise the rate of achievement rate of blood pressure,improve clinical symptoms,improve the function of vascular endothelium,regulate inflammatory factors.Improve blood pressure and TCM syndrome efficacy.