The Changes Of Vascular Endothelial Function Study In Essential Hypertension Phlegm Syndrome After Wendan Capsules Intervention

Objective:To analysis the correlation between FMD,IMT and other indexs on essential hypertension phlegm syndrome patients with vascular endothelial dysfunction, as well as discuss the possible mechanisms of WenDanXieZhuo treatment on endothelial dysfunction through observation of the effect of Wendan capsules.Methods:42 patients with essential hypertension phlegm syndrome were divided into two groups,22 patients were in group of WenDan capsules treatment,another 20 patients were in group of placebo treatment.There were 12 males and 10 females in treatment group,aged from 41 to 60 years old,mean age were 48.9±5.96 years,average course were 4.68±3.01 years.There were 11 males and 9 females in control group,aged from 40 to 60 years old,mean age were 49.5±6.33 years,average course were 4.60±3.38 years.All of the patients took Amlodipine(Norvasc,5mg/pill,provided by Pfizer company) to control the blood pressure,5-15mg/times,once a day.Based on the effective control of blood pressure(SBP≤140mmHg,DBP≤90mmHg),the treatment group patients took WenDan capsules,control group patients took placebo.Usages of WenDan capsules:take three capsules once and three times each day,three months for a period and take it for two periods.Placebo are provided by pharmacy department of the First Affiliated Hospitial,and the usage are the same as WenDan capsules.Collect the TCM symptoms integrate of the patients before and after treatment,and detect the lipid level,endothelium-derived relaxing factor(NO) level and endothelin-1(ET-1) level in peripheral blood.Carotid IMT,plaques integrate,FMD and NID were measured by color doppler ultrasound.Results:1.Spearman correlation showed that FMD had significant correlation with TG level(r=0.436,p<0.01).IMT was correlated with SBP and NO/ET-1,especially it had significant positive correlation with PP,total plaques integrate,sofe plaques integrate TCM symptoms integrate and TC level(p<0.01),and negative correlation with HDL-C level(r=-0.674,p<0.01).Multiple linear regressions showed that IMT=1.296+0.032×TCM symptoms integrate -0.289×HDL-C(R~2=0.650, p<0.05).2.The EDD of treatment group patients were much improved after 6 months therapy(p<0.01),and there are significant differences between two groups(7.82±2.12vs6.04±3.02%,P=0.032).However,the NID was no differences between them.3.After 6 months therapy,there were significant differences in Carotid IMT between two groups(1.16±0.15vs1.34±0.14mm,p<0.01).The total carotid plaques integrate,sofe plaques integrate and hard plaques integrate of treatment group patients were obviously reduced than before(p<0.01),but have no significant differences with control group.4.The level of NO in treatment group after 6 months were 47.01±0.18μmol/L,they were obviously increased than before and have significant differences with control group(p<0.05).And the level of ET-1 were reduced in both groups,but there was no differences between them(70.48±13.19 vs 71.16±12.73Pg/L,p>0.05).5.After WenDan capsules treatment,the level of cholesterol(TC),TG,and low density lipoprotein(LDL-C) were reduced and the high density lipoprotein (HDL-C) were increased,but have no significant difference than before(p >0.05),comparing with control group,both TC(4.42±0.77 vs 4.96±0.79mmol/L, p=0.029) and HDL-C(1.22±0.23vs1.06±0.26mmol/L,p=0.041) were have significant differences.6.After 6 months therapy,the TCM symptons integrate decreased obviously and much lower than control group(p<0.01).The symptoms of dizziness, headaches,bosom frowsty,vomiting sputum,palpitation,insomnia and loss of appetite were significant improved after 6 months therapy in treatment group, comparing with control group,symptoms of dizziness,headaches and insomnia have greatly improved(p<0.05). Conclusion:1.Essential Hypertension patients have low FMD,low NO level and higt ET-1 level,which point out that there were significant vascular endothelial disfunction in essential hypertension patients.FMD was only correlated with TG level,but had no significant correlation with other indexs,however,carotid IMT had significant it has significant correlation with clinic symptoms, plaque integrate and peripheral blood lipid level,as a result,we can deduce that FMD combinated with IMT can reflect the extent of vascular lesions on hypertension more Accurately,and progress of the disease more predictie.2.WenDan capsules can exactly improve hypertension clinical symptoms, reduce the thickness of IMT,improve the FMD and balance the level of lipid, NO and ET-1.It proved that WenDanXieZhou method can strengthen healthy qi to reduce pathogenic factors,so we can conclude that WenDan capsules can improve the disfunction of endothelial,delay and reverse the process of atherosclerosis .