The Effect And Mechanism Discussion Of Compound Gastrodia Elata Antihypertensive Granules On Blood Pressure Variability In Patients With Yin Deficiency And Yang Hyperactivity

Objective: To observe the indexes of blood pressure variability in essential hypertension patients with Yin deficiency and Yang hyperactivity by Compound Gastrodia Elata Antihypertensive Granules and heart rate,heart rate variability(HRV),nitric oxide(NO)and vascular endothelin-1(ET-1)before and after treatment,superoxide dismutase(SOD),renin(RENIN),angiotensin II(Ang II),aldosterone(ALD)and other indicators of change that is to evaluate the effect of Compound Gastrodia Elata Antihypertensive Granules on blood pressure variability in patients with Yin deficiency and Yang hyperactivity objectively and explore the possible mechanism.Methods: 60 cases of essential hypertension patients with Yin deficiency and Yang hyperactivity were randomly divided into observation group and control group with 30 cases each.Patients in the two groups were treated with irbesartan and(or)amlodipine as the basic antihypertensive drugs.The observation group was given Compound Gastrodia Elata Antihypertensive Granules orally with 8 weeks.Observed two groups before and after treatment of 24 HSBP,24 HDBP,DSBP,DDBP,NSBP,NDBP,24 HSBPV,24 HDBPV,DSBPV,DDBPV,,NSBPV,NDBPV and heart rate,HRV,SOD,NO and ET-1,RENIN,Ang Ⅱ,ALD index change and curative effect of traditional Chinese medicine such as evaluation index,security,etc,the data obtained through statistical analysis,evaluation of curative effect.Results: 1.Comparison of 24 hSBP,24hDBP,DSBP,DDBP,NSBP and NDBP: After treatment,the levels of 24 hSBP,24hDBP,DSBP,DDBP,NSBP and NDBP in the two groups were significantly lower than before treatment(P<0.05),and there was a difference between the two groups(P<0.05).2.Comparison of 24 hSBPV,24hDBPV,DSBPV,DDBPV,NSBPV and NDBPV: After treatment,the blood pressure variability index in the observation group was significantly decreased compared with that before treatment(P<0.01).In the control group,24 hSBPV,24hDBPV,DDBPV,NSBPV and NDBPV before and after treatment decreased(P<0.05),while there was no statistical difference before and after DSBPV treatment(P>0.05).After treatment,24 hSBPV,DSBPV and NSBPV in the observation group showed statistical difference(P<0.05),among which 24 hSBPV and DSBPV showed significant difference(P<0.01),while 24 hDBPV,DDBPV and NDBPV showed no statistical difference with the control group(P>0.05).3.Comparison of heart rate and HRV related indexes: SDN,SDANN,RMSSD and pNN50 of the two groups increased after treatment,and there was significant difference(P<0.05).There was significant difference between the groups(P<0.05).Observation group After treatment,the heart rate decreased,which was statistically significant(P<0.05).There was no significant difference in heart rate between the two groups(P>0.05).There was significant difference between the two groups(P<0.05).4.Comparison of NO,ET-1 and SOD: After treatment,the levels of NO and SOD in the control group and the observation group were significantly increased(P<0.05),and there were significant differences between the groups(P<0.05).After treatment,the level of ET-1 in the control group and the observation group was significantly reduced(P<0.05),and there was a significant difference between the two groups(P<0.05).5.Comparison of RENIN,Ang Ⅱ,ALD: Observation group and control group after treatment RENIN than before treatment had no statistical difference(P > 0.05),Ang Ⅱ,ALD is decreased(P < 0.05)before treatment and comparison between groups had significant difference(P < 0.05).6.Comparison of TCM syndrome score and comprehensive efficacy: In terms of TCM syndrome score,both groups showed a decrease after treatment(P<0.05),and there was a statistical difference between the two groups(P<0.05).In terms of comprehensive curative effect after treatment,the total effective rate of the observation group was 96.67%(10 cases,19 cases,1 case were significant effective,effective and ineffective respectively);the total effective rate of the control group was 83.33%(5 cases,20 cases,5 case were significant effective,effective and ineffective respectively),the comparison between the groups was statistically significant(P <0.05).Conclusion: 1.The treatment of EH patients with Yin deficiency and Yang hyperactivity with the combination of Compound Gastrodia Elata Antihypertensive Granules,amlodipine tablets and irbesartan tablets is superior to the treatment with western medicine alone in lowering blood pressure,improving BPV,increasing HRV,serum NO and SOD levels,reducing serum et-1 level,regulating the RAAS system and improving clinical symptoms.2.Compound Gastrodia Elata Antihypertensive Granules can effectively assist EH patients to reduce blood pressure,improve BPV,adjust heart rate and HRV,increase serum NO and SOD levels,reduce serum ET-1 levels,regulate the RAAS system,and improve clinical symptoms without obvious adverse reactions.In terms of improving BPV in patients with hypertension,Compound Gastrodia Elata Antihypertensive Granules had better effect in improving systolic blood pressure variability than diastolic blood pressure variability.3.The possible mechanism of Compound Gastrodia Elata Antihypertensive Granules reducing BPV in EH patients with Yin deficiency and Yang hyperactivity is:(1)By adjusting heart rate and HRV,the sympathetic nervous system function is improved,thereby reducing BPV.(2)By increasing the serum NO and SOD level,reducing the serum levels of ET-1,Ang Ⅱ,improve endothelial function,thereby reducing BPV.(3)By lowering serum Ang Ⅱ,ALD levels,adjust the RAAS system,thereby reducing BPV.