Study On The Effect And Mechanism Of Nourishing Yin And Lowering Blood Pressure Prescription In Treating Primary Hypertension With Yin Deficiency And Yang Hyperactivity

Objective With the guidance of the theory of traditional Chinese medicine,the treatment of yin deficiency and yang hyperactivity in patients with essential hypertension is treated with the prescription of nourishing yin and lowering blood pressure.The comparison between perindopril and perindopril of Western medicine was used as the positive control,and the clinical effect was compared.To observe the efficacy and safety of Yangyin Jiangya recipe in improving clinical symptoms,reducing blood pressure,anti-inflammatory and protecting vascular endothelial function,and to explore the mechanism of Yangyin Jiangya recipe in treating essential hypertension.Method All of the 69 patients were hospitalized in the Department of cardiovascular medicine in the hospital of integrated traditional Chinese and Western medicine in Wuhan(October 31,2016 to October 31,2017).Diagnosis of primary hypertension and TCM syndrome differentiation of yin deficiency and yang hyperactivity syndrome.By the method of random number table,randomly divided into two groups,control group 34(Perindopril Tablets,4mg,oral,1 times /d),35 cases in observation group(Yin Jiangni decoction,200 ml,oral,2/d+conventional western medicine).The two groups were treated for 3 months.The scores of TCM syndromes were calculated before and after treatment,and the efficiency of TCM syndrome improvement was calculated and compared;The blood pressure in the consulting room(measure 3 times,take the mean value)and 24 hour ambulatory blood pressure were measured before and after treatment,and the comparison was made;Blood Hcy and hs CRP were detected and compared before and after treatment;FMD,ET-1and NO were detected before and after treatment,and their changes were compared;The safety analysis of blood and urine routine,liver and kidney function and electrocardiogram test before and after treatment were completed.The measured data in the data were expressed by mean + standard deviation(x ±s).The t test was used in comparison between the groups.Chi square test was used to count data,and P<0.05 was statistically significant.Use the statistical software SPSS18.0 to perform the operation.Result(1)Comparison of TCM syndromes: compared with before treatment,the total score of TCM syndrome in the observation group and the control group after treatment was lower(P < 0.05);compared with the control group,the total score of TCM syndrome after treatment was low(P < 0.05).The effective rate of TCM syndrome improvement in the observation group was significantly better than that in the control group(P < 0.01).(2)Compared with the control group,the effect of the observation group was significantly higher than that in the control group(P<0.05).The blood pressure in consulting room:compared with before treatment,after treatment,two groups of consulting room systolic blood pressure and diastolic blood pressure were lower in the consulting room,significant difference was statistically significant(P<0.05);compared with the control group,the observation group after the treatment of consulting room consulting room systolic and diastolic blood pressure were lower(P<0.05).(3)Comparison of ambulatory blood pressure:compared with before treatment,after treatment,two groups of 24 h SBP,24 h DBP,24 h MAP,d SBP,d DBP,d MAP,n SBP,n DBP and n MAP were lower(P<0.05),in addition to the control group n DBP;compared with the control group,the observation group after treatment,24 h SBP,24 h DBP,24 h MAP,d SBP,d DBP,d MAP,n SBP,n DBP and n MAP were lower(P<0.05),except d DBP.(4)Comparison of blood pressure load:compared with before treatment,d SBPl,d DBPl,n SBPl and n DBPl were decreased in all groups after treatment(P<0.05).Compared with control group,d SBPl,d DBPl,n SBPl and n DBPl were lower in the observation group(P<0.05).(5)Comparison of blood pressure variability:compared with before treatment,d SBPv,d DBPv,n SBPv and n DBPv were lower in two groups after treatment(P<0.05).Compared with the control group,d SBPv and d DBPv were lower(P<0.05),n SBPv and n DBPv were slightly lower than those in the control group,and the difference was not statistically significant(P>0.05).(6)Comparison of blood Hcy and hs CRP:compared with before treatment,after treatment,the observation group of blood Hcy and hs CRP were lower(P<0.05),the control group was also decreased,but the difference was not significant(P>0.05);compared with the control group,the observation group of blood Hcy,hs CRP low(P<0.05).(7)The two groups before treatment,FMD,ET-1,NO level is basically the same,compared with before treatment,after treatment to observe the level of NO,FMD group increased significantly(P<0.05),the level of ET-1 decreased significantly(P<0.05);compared with the control group,higher FMD and NO levels after treatment in the observation group(P<0.05).The level of ET-1 significantly decreased(P<0.05),that Yin antihypertensive decoction can to some extent improve the diastolic function in patients with vascular.Compared with before treatment,the FMD,NO and ET-1 were improved in the control group after treatment,but there was no statistical difference(P>0.05).(8)There were no significant differences between before and after treatment of blood,urine,liver and kidney function,electrocardiogram(P>0.05),the clinical test is safe.Conclusion On the basis of conventional treatment in western medicine,the treatment of essential hypertension by oral administration of Yangyin Jiangya recipe can further reduce blood pressure,improve clinical symptoms,antiinflammatory,improve vascular endothelial function and reduce the risk of cardiovascular and cerebrovascular diseases.It is suggested that the mechanism of lowering blood pressure by Nourishing Yin and lowering blood pressure may be related to its anti-inflammatory and improvement of vascular endothelial function.