Evaluation Of Qianyang Yuyin Granules In Improving Early Renal Damage In Elderly Hypertension Based On Shear Wave Elastography

Objective:Using ultrasonic shear wave elastography(SWE)technology,serum fibrosis related indexes and renal tubular injury markers,to evaluate the effect of Qianyang Yuyin granules combined with western medicine on the degree of renal fibrosis in elderly patients with hypertension and early renal damage.Methods:A randomized,parallel control and prospective clinical study design was adopted.Forty patients with TCM syndrome differentiation of hypertension,Yin deficiency and Yang hyperactivity,were randomly divided into the experimental group and the control group,with twenty cases in each group.Based on the standard regimen(renin angiotensin system inhibitors),this study investigated whether Qian yang Yu yin granules could improve the early renal damage in the elderly with hypertension by inhibiting the fibrosis response and reducing the expression level of renal tubular injury markers.Results:①After treatment,the scores of TCM symptoms in the experimental group were significantly lower than that in the control group(P<0.01);In terms of the comparison of TCM syndrome efficacy,the effective rate of the experimental group was 61.1%,and the effective rate of the control group was 22.2%.The efficacy of the experimental group was significantly better than that of the control group(P<0.05).②The systolic blood pressure,diastolic blood pressure,and pulse pressure difference between the two groups after treatment were not different(P>0.05),but the systolic blood pressure and pulse pressure difference of the experimental group after treatment were better than those before treatment(P<0.01).③After treatment,the serum TGF-β expression level of the experimental group was significantly lower than that of the control group(P<0.01),the serum HA,LN,and P Ⅲ-NP expression levels were significantly lower than that of the control group(P<0.05),and the serum Ⅳ-C expression The level has not decreased significantly(P>0.05).④ After treatment,the expression levels of urine NGAL,KIM-1 and IL-18 in the experimental group were significantly lower than those in the control group,and there was a very significant difference(P<0.01).⑤ After treatment,the Emean value of Young’s modulus in the experimental group was significantly lower than that in the control group(P<0.01),the Young’s modulus of the experimental group before and after treatment was significantly different from that before treatment(P<0.01).Conclusion:① Qian yang Yu yin granules combined with antihypertensive drugs can significantly improve the traditional Chinese medicine syndrome and related clinical symptoms in patients with renal damage caused by Yin deficiency and Yang hyperactivity.②Qian yang Yu yin granules combined with western medicine can reduce the levels of systolic blood pressure and pulse pressure difference in patients with early hypertension and renal damage.③Qianyang Yuyin granules combined with western medicine can significantly reduce the contents of NGAL,KIM-1 and IL-18 in patients with hypertension and renal damage.④Qian yang Yu yin granules combined with western medicine can reduce high blood pressure in patients with renal damage TGF-beta,HA and LN in serum,the expression of P Ⅲ-NP levels,no obvious adverse reactions during treatment is safe and effective.⑤Shear wave elastography can assist in assessing the extent of renal damage in patients with hypertension.Qian yang Yu yin granules combined with western medicine can improve the degree of renal fibrosis in patients with hypertension renal damage,restore renal elasticity,and thereby reduce the Young’s modulus of their kidneys.