| Study of the therapy principle (activating the blood circulation, removing the phlegm, lowering the liver Yang and invigorating Qi) on essential hypertension with left ventricular hypertrophy. Essential hypertension with left ventricular hypertrophy (EH-LVH) was considered as an independent cardiovascular dangerous factor. The rates of angina, arrhythmia and heart failure in EH patients with LVH were significantly higher than those in EH patients without LVH. The tissue of left ventricular remodeled, comprising the hypertrophy of cardiocyte and the fibrosis of interstitial of heart. Besides blood pressure, there exists more nervous and body fluid factors which influences the development of LVH. The current therapy of western medicine was fairly good at lowering blood pressure and left ventricular mass index (LVMI), however was not quite good at recovering the course of fibrosis. It could be discovered that most of the patients of EH-LVH were middle-aged and the course of the disease was long. The symptoms include headache, whirl, testiness, and string pulse et al, which belonged to the syndrom of up-floating of the liver-Yang, it also include atony, stuffy of the chest, white and dim tongue, et al, which belongs to the syndrome of Qi deficient, blood stasis and phlegm assembling. The symptoms of deficiency of Liver-Yin and Kidney-Yin such as feverish sensation of five centers, soreness of waist, tinnitus, hectic fever, night sweat and dry taste, et al, were common in early stage EH patients, but seldom in EH-LVH patients. The activity of RAS (renin-angiotensin system) and the content of noradrenaline(NE) in the patients of EH-LVH with state of up-floating of liver-Yang was significantly higher than ~4i~ that in the others. By combining the view of Traditional Chinese Medicine (TCM) with the study of western medicine on pathophysiology of LVH, we think the rise of the content of NE and the function of RAS in cardiot issue were similar with the syndrome of up floating of the liver Yang of TCM. Because the RAS caused the cells of cardio in a stasis of tense and stress, such as the contract of vascular smooth muscular cell, the hypertrophy of cardiocyte, and the increment of fibroblast. The depression of energy metabolism and the changes caused by it in hypertrophy cardiocyte was similar with the deficiency of Qi of TCM. Furthermore, the turbulence of microcirculation in cardio interstitial was similar with the blood stasis of TCM. The accumulation of mucopolysaccharides in cardio interstitial possibly belongs to the pathophysiology of phlegm syndrome. On the basis of analysis above, the therapy principal as activating the blood circulation, removing the phlegm, lowering the liver Yang and invigorating Qi were adopted.XingJiKang(XJK) pill was made for the patients with EH-LVH. Seventy patients were divided into observation group (treated by XJK) and control group (treated by Betaloc). All patients received treatment for three months. It indicated that XJK could lower the blood pressure and LVMI, improve the fibrosis index including serum procollagen typeâ…¢ (PCâ…¢) and hyaluronic acid (HA), hemorheology index, and the life quality. The further experiment study showed that XJK could improve both the systolic and diastolic function of the isolated heart of spontaneous hypertension rat, reduce the content of collagen, HA and angiotensin â…¡, could improve the activity of enzyme of... |
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