Clinical Research Of Both Qi And Yin-type Of Primary Hypotension Patients By TCM Of Balanced Elevating Blood Pressure Of Qiwei-pingheng-shengya Decoction

Objectives:To observe the clinical efficacy,safety and 24 hour ambulatory blood pressure evaluation in the treatment of deficiency of both qi and yin-type of Primary Hypotension patients by TCM of balanced elevating blood pressure of qiwei-pingheng-shengya decoction; To evaluate the advantages and disadvantages of TCM of qiwei-shengya decoction; To discuss the new methods and means of diagnosis and treatment of primary hypotension by means of combining traditional Chinese and Western medicine; To suggest the new diagnosis standard of primary hypotension using ABPM.Methods:58 patients of primary hypotension with type of deficiency of both qi and Yin were randomly selected to evaluate clinical symptoms,CBP and ABPM with 24hSBP,24hDBP,dSBP,dDBP,nSBP,nDBP,BPL,BPV, HR and other relevant indicators of adverse reactions before and after 4 weeks of treatment. Method of administration: patients taked TCM of balanced elevating blood pressure of qiwei-pingheng-shengya decoction 200ml three times a day for 4 weeks.Results:1.The improvement of TCM symptoms:Symptoms of fatigue, weakness, lumbar debility, dizziness, palpitation, insomnia, forgetfulness etc. were disappeared or relieved obviously after treatment in patients with type of deficiency of both qi and Yin. And the changing of symptoms were faster and more obvious than blood pressure.2. Casual blood pressure (CBP) effect:CBP was significantly increased after treatment compared with those before treatment (121.97 ± 16.71/71.10 ±9.15 vs 105.76±21.55/60.33±11.03 mmHg, P<0.01).And CBP value after treatment was higher than value of 24 hour-average blood pressure (121.97±16.71/71.10±9.15 vs 114.26±11.02/66.02±7.67, P<0.01) due to white coat effect.3.The changes of average value and load of ambulatory blood pressure:(1)24 hour-average blood pressure was significantly increased after treatment compared with those before treatment (114.26 ± 11.02/66.02 ± 7.67 vs 102.21±8.91/60.03± 4.99mmHg, P<0.01);And 24hSBP value after treatment was higher than value of 24hDBP (12.05±10.34 vs 5.98±7.78mmHg, P<0.01);(2)Daytime-average blood pressure was significantly increased after treatment compared with those before treatment (116.22±11.33/67.28±7.79 vs 104.07±8.90/61.31±5.51mmHg, P< 0.01),And dSBP value after treatment was higher than value of dDBP (12.07± 15.18 vs 5.92±11.46mmHg, P<0.01);(3)Nocturnal-average blood pressure was significantly increased after treatment compared with those before treatment(108.16 ±13.51/61.91 ±8.59 vs 97.09±10.92/56.55±6.16mmHg, P<0.01);And nSBP value after treatment was higher than value of nDBP (10.81 ± 14.42 vs 5.20± 11.43mmHg, P<0.01); (4) Daytime blood pressure load was significantly increased after treatment compared with those before treatment (9.49±14.06/3.86± 11.92 vs 2.19±4.12/0.26±1.10%, P<0.05);(5)Nocturnal blood pressure load was significantly increased after treatment compared with those before treatment (16.10 ±24.62/7.72±20.20 vs 3.86±11.60/0.67±2.30%, P<0.01);(6)Daytime low blood pressure load was significantly reduced after treatment compared with those before treatment (1.38±5.26/21.15±24.76 vs 8.62±15.24/39.31±33.96%, P< 0.01);(7)Nocturnal low blood pressure load was significantly reduced after treatment compared with those before treatment (2.68±6.68/21.84±25.23 vs 14.56± 21.14/39.65±35.21, P<0.01)4. The changes of variability of blood pressure:(1)24 hour blood pressure standard deviation was not changed significantly after treatment compared with those before treatment (10.27±2.56/6.53±1.67 vs 9.60±2.16/6.09± 1.72mmHg, P>0.05);(2)Daytime blood pressure standard deviation was not changed significantly after treatment compared with those before treatment (8.32± 2.44/5.76±1.49 vs 7.60±2.05/5.52±1.89mmHg, P>0.05);(3)Nocturnal blood pressure standard deviation was not changed significantly after treatment compared with those before treatment (7.61±2.84/5.87±1.99 vs 6.59±2.39/5.58± 1.88mmHg, P>0.05)5.The change of HR:(1) After treatment the 24 hour heart rate was faster than before treatment (70.13±12.76 vs 67.23±11.71bpm, P<0.01);(2)After treatment the daytime heart rate was faster than before treatment (74.57±12.46 vs 71.68± 11.39bpm, P<0.01);(3)After treatment the nocturnal heart rate was faster than before treatment (62.73±9.37 vs 59.82±7.84bpm, P<0.01)6. Adverse reactions and safety:The treatment process is safe and effective. Those adverse reactions such as mild diarrhea, palpitations, facial flushing were less(7%).Conclusions:1.The clinical symptoms of primary hypotension of type of deficiency of both qi and yin can be relieved obviously and can be also improved the quality of life by TC M of Qiwei-pingheng-Shengya decoction, however, the changing of symptoms were faster and more obvious than blood pressure.2.Qiwei-pingheng-Shengya decoction has obvious effect to casual blood pressu re(SBP and DBP).3.Qiwei-pingheng-Shengya decoction can significantly enhance the values of 24 hSBP,dSBP, nSBP and 24hDBP,dDBP, nDBP,but the rising extent of DBP were lowe r than that of systolic blood pressure. And no significant changed of BPV,but BPL and MABP increased or low-BPL decreased after treatment.4.CBP overestimated the pressor effect of Qiwei-pingheng-Shengya decoction c ompared with ABPM in this study.5.Qiwei-pingheng-Shengya decoctioncan also improve the heart rate and increas e myocardial contractility.6.Qiwei-pingheng-Shengya decoction is effective, safe and less adverse reacti on in clinical practice.