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Literature studyIn the TCM literature study section, Review briefly on ancient research of dizziness, headache in the representative literatures of Chinese traditional medicine since "Internal Classic of Huang Di".Discuss the understanding of hypertension in modern medicine;introduce the academic viewpoint on hypertention of Professor Wang Qinghai.To indicate a deepening development on understanding hypertention in TCM.In the western literature section, Summarize comprehensively of the epidemiology of isolated systolic hypertension, harm, clinical characteristics, pathogenesis, treatment, and with the relationship between inflammation.The literature above indicates the methods and achievement on isolated systolic hypertension of TCM and the western medicine, which has laid a good theroretical foundation for clinical and experimental research.2.1 PurposeTo observe the effect of compound QiMa capsule on blood pressure and pulse pressure in rats of isolated systolic hypertension model. Select the high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α) as the observed indicators of inflammation, and study the intervention effect of compound QiMa capsule on inflamation in rats of isolated systolic hypertension model. Evaluate on Compound QiMa capsule treating of isolated systolic hypertension and its effects on inflammatory cytokines.We established rat model of isolated systolic hypertension with warfarin sodium and vitamin K modeling methods(WVK model). The rats were divided into normal group, control group, nifedipine group, compound QiMa Capsule low dose group, compound QiMa Capsule medium dose group, compound QiMa capsule high dose group, each group was given the appropriate treatment measures, for 4 weeks. Observed effects of compound QiMa Capsule on blood pressure, pulse pressure, and high sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), tumor necrosis factor a(TNF-α) in isolated systolic hypertension rats.(1)After modeling, rats showed different degrees of listlessness, loose skin, hair, haggard, tail cyanosis cold, loose stool, such as performance. After treatment, nifedipine group and the 3 compound QiMa Capsule groups had a significantly symptom scores improvement compared with the control group(P<0.01), the low and medium dose group of compound Qi Ma Capsule showed no difference compared with the nifedipine group (P> 0.05), but the high dose group was significantly superior to the nifedipine group (P<0.01), and no difference with the health group.(2)Changes in systolic blood pressure of each group. Nifedipine group decreased systolic blood pressure significantly in the first week after Lreatment (P<0.01), while all the compound Capsule QiMa groups didn't decrease the blood pressure obviously.2 weeks after treatment,the high dose compound QiMa capsule group decreased significantly compared with control group, while the low dose and medium dose group didn't indicate any difference.(3)Changes of diastolic blood pressure in each group. Nifedipine group showed it significantly decreased diastolic blood pressure after 2 week's treatment compared with control group(P<0.01), and with itself before treatment (P<0.01). Those compound QiMa capsule goups decreased slowly and had no obvious trend (P>0.05).(4)Changes of pulse pressure in each group. Pulse pressure in all model groups were higher than the health group before treatment. Nifedipine group began to decrease in 1st week, it was significantly different compared with control group in the same time (P<0.05).There was little pluse pressure change in all the compound QiMa groups in the beginning of treatment. High dose group was statistically significant compared with the control group (P<0.05) in the first week. The low dose group and the medium dose group were to emerge treatment differences after 4 weeks. The high dose group reduce the pulse further at this time, compared with itself before treatment, control group and the nifedipine group, it had extremely and significantly difference (P<0.01).(5)Hs-CRP change in each group. Both nifedipine group and high dose group were significantly different compared with the control group (P<0.01), medium dose group was also statistically significant compared with the control group(P<0.05), while there were extreme significance when the high dose group compared with the low dose group, and with the medium dose group (P<0.01), it also had significance compared with the nifedipine group (P<0.05).(6)IL-6 change in each group. Compared with control group, nifedipine group, low dose group, and medium dose group, there were significantly different in the high dose of compound QiMa group(P<0.01), while the rest of the treatment groups showed no significant difference compared with control group.(7)TNF-a change in each group. There were extremely significant diffenent in nifedipine group,medium dose group and high dose group, compared with the control group (P<0.01), but not significantly different in low dose group. The high dose group was significant different compared with nifedipine group (P<0.05), and with low dose group(P<0.01).(1) Model of isolated systolic hypertension can be copied by fedding rats with warfarin and subcutaneous injecting vitamin K1.(2) Compound QiMa capsule can improve mental state and other general conditions in isolated systolic hypertension rats, particularly in the high dose group.(3) Compound QiMa capsule can reduce systolic blood pressure in isolated systolic hypertension rats, particularly in the high dose group.(4) Compound QiMa capsule had no obvious effect on isolated systolic hypertension rats.(5) Compound QiMa capsule can reduce pulse pressure in isolated systolic hypertension rats, particularly in the high dose group.(6) Compound QiMa capsule can obviously reduce hs-CRP levels in isolated systolic hypertension rats.(7) Compound QiMa capsule can obviously reduce IL-6 levels in isolated systolic hypertension rats.(8) Medium dose and high dose of Compound QiMa capsule can reduce TNF-αlevels in isolated systolic hypertension rats, particularly obvious in the high dose group.To observe effect of the compound QiMa capsule on clinical symptoms, blood pressure, pulse pressure,24-hour ambulatory blood pressure and inflammatory factors in isolated systolic hypertension and to evaluate clinical efficacy of the compound QiMa capsule, and the effect of its intervention on inflammatory factors in vivo.80 eligible patients of isolated systolic hypertension diagnosed to the TCM syndrome of Qi deficiency and turbid phlegm were enrolled, and then ramdomly divided into control group and treatment group.Control group received oral nifedipine, and treatment group received oral compound QiMa capsule, for 4 weeks' therapy, respectively.Observed changes of blood pressure, pulse pressure,24-hour ambulatory blood pressure, high sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and tumor necrosis factor (TNF-α) in each group.(1)The symptom score of TCM descrease obvious significantly in treatment group compared with control group;There was statistical significance between the two groups after treatment (P<0.01). It showed that the treatment group improved clinical symptoms better than the control group. (2) Comparison of antihypertensive efficacy of the two groups after treatment. The total efficiency by test has no significant difference between the two group(P>0.05). It suggested that the effect of antihypertensive in the two group was similar.(3) Comparison of random blood pressure test. Blood pressure in control group was significantly lower than the treatment group after the 1st week's treatment. Until the 4th week, the systolic blood pressure levels of treatment group were not significantly different from control group, but there was more significant decline by diastolic blood pressure in control group than the treatment group (P<0.01).(4) Comparison of ambulatory blood pressure before and after treatment. Both two group had obviously decreased blood pressure after treatment than before treatment (P<0.01); The control group declined even faster, when reducing systolic blood pressure, it could also decrease diastolic blood pressure significantly.After treatment, diastolic blood pressure in treatment group was significantly higher than control group(P<0.01). As the systolic blood pressure level, the control group was sligntly better than the treatment group,but there was not statistical significance between the two group (P>0.05).(5) Comparison of pulse pressure in the two group. There was no significant difference in pulse pressure between the two group before treatment. Pulse pressure decreased in both groups during treatment, and the treatment group decreased more, it had shown significant differences in the first 2 weeks of treatment (P<0.01).(6) Comparison of inflammatory factors in two group. There was no significant difference in various inflammatory factors levels between the two group before treatment.The control group decreased slightly after treatment, but it was not statistically significant. The treatment group had significantly decreased the levels of inflammatory factors after treatment compared to it before treatment (P<0.05). There were also significant differences compared with the control group (P<0.05).(1)Compound QiMa capsule can significantly improve clinical TCM symptoms in patients with qi deficiency and Phlegm. (2)Compound QiMa capsule has similar effect to nifedipine on treating isolated systolic hypertention patients with Qi deficiency and turbid phlegm syndrome.(3)Compound QiMa capsule can significantly reduce systolic blood pressure in patients with isolated systolic hypertension,while it has no obvious effect on diastolic blood pressure.(4) Compound QiMa capsule can significantly reduce the pulse pressure in elderly patients with isolated systolic hypertension.(5) Compound QiMa capsule can significantly reduce the level of inflammatory factors in vivo of patients with isolated systolic hypertension, which suggests that it can inhibit inflammation of the body. |
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