Clinical Application, Based On Isolated Systolic Hypertension Syndromes

Objective:To observe the effect of JiangYa capsule combined with nimodipine on elderly isolated systolic hypertention(EISH) from depressurization and improving clinical symptoms,discuss the mechanism in treating hypertension and protecting vascular endothelial function,hypertensive nephrine injury and arterial elasticity,and provide clinical evidence for EISH treatment with combination of disease and syndrome method.Methods:135 males and females EISH patients from 60 to 80 years old were randomly assigned to Jiangya capsule group(group 1),Jiangya capsule combined with nimodipine group(group 2) and nimodipine group(group 3).Group 1 were administrated with Jiangya capsule 3 tablets tid and nimodipine placebo 1 tablet tid;Group 2 were administrated with Jiangya capsule 3 tablets tid and nimodipine 1 tablet tid;Group 3 were administrated with nimodipine 1 tablet tid and Jiangya capsule placebo 3 tablets tid.The course of treatment was 4 weeks.To obseve the symptom cumulative scores,blood pressure,plasm NO,hs-CRP,TXB₂,6-Keto-PGF-1α,ET-1 and five projects of early nephrine injury(MALB,TRF,NAG,β-2MG,IGU) before and after the test,and Short Form-36 was finished at the same time.Results:1.Depressuriation effect:Systolic blood pressure decreased in all groups after 4 weeks of treatment(P＜0.05),and diastolic blood pressure was almost the same after treatment(P＞0.05);There was statistic significant difference on the systolic blood pressure between group 2 and group 3,but there was no statistic significant difference on the systolic blood pressure between group 1 and group 3.2.Symptom improvement:There was statistic significant difference on total score of symptoms in all groups before and after test(P＜0.05).There was statistic significant difference on total scores of symptom between the group 1 and group 3,group 2 and group 3(P＜0.05).The total efficiency was higher in group 1 and group 2 than that in group 3(P＜0.05).It manifested that the group 1 and 2 were superior to the group 3 in alleviating TCM symptoms.3.Quality of life:Physical function,role physical,body pain,social function,role emotion and mental health of group 1 were improved after treatment(P＜0.05);Physical function,role physical,body pain,social function,general health,vitality,role emotion and mental health of group 2 were improved after treatment(P＜0.05);Body pain of group 3 improved after treatment(P＜0.05).There was statistical significant difference on physical function,role physical,body pain,social function and role emotion between group 1 and group 3(P＜0.05);There were statistical significant difference on physical function,role physical,body pain,vitality,social function,role emotion and mental health between group 2 and group 3(P＜0.05);4.Lab examination:Hs-CRP,TXB2 and ET-1 were reduced in all groups after the treatment(P＜0.05,),and the NO and 6—Keto-PGF_1α were elevated after the treatment (P＜0.05).There was no difference among all groups after treatment(P＞0.05),except TXB₂.It showed that Jiangya Capsule combined with nimodipine could protecting endothelium function from reducing ET-1 and TXB2 and raising NO and 6—Keto-PGF_1α.5.Early nephrine injury:MALB andβ2—MG were reduced signifcantly in all groups (P＜0.05),and there was no difference on TRF,IgU and NAG in all groups after the treatment(P＞0.05).There was no statistical significant difference among all groups(P＞0.05);Conclusion:Jiangya capsule combined with nimodipine have better depressuriation for yin deficiency and yang hyperactivity syndrome patients than nimodipine.Combination of disease and syndrome method can improve patients' clinical symptoms and the effect of depressuriation.Treatment with integrated Chinese and western medicine can improve the quality of life.Jiangya capsule combined with nimodipine can protect vascular endothelial function and early hypertensive nephrine injury.