Clinical Observation On The Treatment Of H-type Hypertension With Yin Deficiency And Yang Hyperactivity Syndrome By Pingyang Jiangya Prescriptio

Objective: To observe the changes of 24-hour ambulatory blood pressure mean value and circadian rhythm of blood pressure,fasting blood homocysteine(Hcy)level and TCM syndrome score in patients with type H hypertension with yin deficiency and yang hyperactivity treated by Pingyang Jiangya Decoction combined with enalapril maleate folic acid tablets and enalapril maleate folic acid tablets alone,and to evaluate its efficacy and safety,so as to provide reference for the treatment of type H hypertension.Methods: The patients who were treated in the outpatient and inpatient departments of the Department of Cardiovascular Medicine of the Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine were selected,and 72 patients who met the inclusion criteria were randomly divided into two groups.The control group was given conventional western medicine treatment(enalapril maleate 10 mg,folic acid 0.8 mg,one tablet a time,one time a day),On the basis of the control group,the experimental group was given the addition and subtraction of Pingyang hypotensive formula(Uncaria tenuifolia 12 g,Bidens bipinnata 30 g,Cassia chinensis20 g,earthworm 10 g,mother of pearl 12 g,medlar 12 g,plantain seed 10 g,chrysanthemum morifolium 15 g,a dose of 300 m L per day,150 m L in the morning and evening)at the same time.The treatment period was 4 weeks.The average value of 24-hour ambulatory blood pressure and the circadian rhythm of blood pressure were observed before and after treatment The fasting plasma homocysteine level and the changes of TCM syndrome indicators before and after treatment were also tested for safety indicators,and the data were statistically analyzed.Results:(1)The general conditions of the two groups of patients were statistically analyzed before treatment.There was no significant difference between the two groups in terms of gender,age,course of disease and basic disease(P >0.05),and the two groups were comparable.(2)TCM syndrome score: there was no significant difference in TCM syndrome score between the two groups at 24 h before treatment(P >0.05),which was comparable.After treatment,the TCM syndrome score of the two groups decreased compared with that before treatment,and the decrease in the experimental group was more obvious,with a statistically significant difference(P <0.05).(3)24-hour ambulatory blood pressure value: there was no significant difference between the two groups in the mean systolic blood pressure and the mean diastolic blood pressure 24 hours before treatment(P >0.05),which was comparable.After treatment,the mean systolic blood pressure and diastolic blood pressure of the two groups decreased compared with that before treatment,and the decrease range of the treatment group was significantly higher than that of the control group,the difference was statistically significant(P <0.05).Change of blood pressure circadian rhythm: there was no significant difference in blood pressure circadian rhythm between the two groups before treatment(P >0.05),and the blood pressure circadian rhythm in the treatment group was improved after treatment.(4)Fasting blood homocysteine: There was no significant difference in fasting blood homocysteine between the two groups after treatment(P >0.05),which was comparable.After treatment,the fasting blood homocysteine in the two groups decreased,and the decrease in the experimental group was more obvious,the difference was statistically significant(P <0.05).Conclusion: Pingyang Jiangya Formula combined with enalapril maleate folic acid tablets can improve the mean value of ambulatory blood pressure and the circadian rhythm of blood pressure,the level of homocysteine in fasting blood,and the score of traditional Chinese medicine syndromes,compared with the simple use of enalapril maleate folic acid tablets,and there are no adverse reactions during the treatment,which can be better applied to clinical practice.