Clinical Observation Of Xianmai Tiaoheng Decoction In Treating Perimenopausal Hypertension Of Kidney Deficiency And Liver Depression

Objective: This dissertation aims to observe treatment on perimenopausal hypertension with kidney deficiency and liver depression.Especially,evaluating the efficacy and safety of Xianmai Tiaoheng decoction combined with Levamlodipine Besilate tablets.Methods: Sixty-six patients diagnosed with perimenopausal hypertension with kidney deficiency and liver depression in the Hypertension Department of Shijiazhuang Hospital of Traditional Chinese Medicine from October 2021 to October 2022 were collected in this study.The patients were randomly divided into treatment group and control group,33 cases in each group.The control group was given Levamlodipine Besilate tablets 2.5mg,twice a day.For the treatment group,Xianmai Tiao-heng decoction 1 dose,200 ml in two times was conducted based on the control group,for 12 weeks.7 aspects(blood pressure level,perimenopausal rating scale score,24-hour ambulatory blood pressure monitoring,coefficient of blood-pressure variation,smoothing index,changes of TCM syndrome score and safety indicators)were observed in initial and treated phases in the two groups individually.Meanwhile,the adverse events occurred during the treatment were recorded in detail.All data were analyzed by e SPSS 26.0 software.Results:(1)Blood Pressure Level Comparison: The blood pressure level decreased after treatment in two groups,and the difference was statistically(P<0.05).After treatment,they were lower in the treatment group than in the control one(P<0.05).Besides,the effective rate of antihypertensive effect was 90.32% in the treatment group and 70.96% in the control group.Thus,the difference was statistically(P<0.05).(2)Perimenopausal Rating Scale Scores Comparison: The scores of the two groups were lower than those before treatment,the difference was statistically significant(P<0.05);There was difference between the treatment group and the control group after treatment(P<0.05).Meanwhile,the treatment group was better than the control group.(3)Comparison of coefficient of variation of blood pressure and smoothness index: the coefficient of variation of 24 hours,daytime and nighttime blood pressure in the two groups before and after treatment were significantly lower than those in the control group(P<0.01).The average blood pressure of 24 hours,daytime and nighttime decreased,and the smoothness index of 24 hours,daytime and nighttime increased,and the differences were statistically significant(P<0.05).After treatment,24 hours systolic blood pressure variation coefficient(24h SBP-cv),24 hours diastolic blood pressure variation coefficient(24h DBP-cv),daytime systolic blood pressure variation coefficient(d SBP-cv),daytime diastolic blood pressure variation coefficient(d DBP-cv)were compared between the two groups.The coefficient of variation of nighttime diastolic blood pressure(n DBP-cv)was significantly lower than that of the control group(P<0.01).The mean blood pressure of 24 hours,daytime and nighttime and the coefficient of variation of nighttime systolic blood pressure(n SBP-cv)in the treatment group were lower than those in the control group.The daytime systolic blood pressure smoothness index(d SBP-SI),daytime diastolic blood pressure smoothness index(d DBP-SI),nighttime diastolic blood pressure smoothness index(n DBP-SI)and nighttime systolic blood pressure smoothness index(n SBP-SI)in the treatment group were higher than those in the control group,and the differences were statistically significant(P<0.05).After treatment,24 h SBP-SI and 24 h DBP-SI had no significant difference between the two groups(P>0.05).(4)TCM Syndrome Scores and Curative Effect Comparison: after treatment,the total TCM symptom scores of the two groups decreased,and the difference was statistically(P<0.05).The treatment group decreased was lower than the control group,and the difference was statistically(P<0.05).The total effective rate of the treatment group was 90.32%,and the total effective rate of the control group was 67.74%.So,the treatment group was better than the control group after treatment,and the difference was statistically significant(P<0.01).(5)Safety analysis: after participants were treated,the blood routine,liver,and kidney function reexamination in two groups showed non-obvious abnormalities.Meanwhile,there is no adverse events occurred during the treatment.Conclusion: Xianmai Tiaoheng decoction combined with Levamlodipine Besilate tablets is effective in the treatment for perimenopausal hypertension with kidney deficiency and liver depression.This treatment can effectively and stably reduce blood pressure and improve the clinical symptoms of perimenopausal hypertension.No obvious adverse reactions occurred during the treatment.