The Clinical Curative Effect Evaluation On Treatment Of Yinxu-Yangkang Type Of Primary Hypertensives By Fixed Changing TCM Of Tianma-Gouteng-Yin Or Lercanidipine Tablets

Objective:To observe the clinical curative effect and contrast evaluation of office blood pressure, ambulatory blood pressure monitoring on treatment of Yinxu Yangkang type of primary hypertensives by fixed changing traditional Chinese traditional Chinese(TCM) of Tianma-Gouteng Yin or lercanidipine hydrochloride tablets.]To roundly evaluate the clinical curative effect and the safety on hypertension treatment by traditional Chinese and western medicine(WM).Methods:124 patients with essential hypertension of Yinxu-Yangkang type were randomly divided into two groups of 62 cases in each group,TCM group were treated with fixed changing TCM of Tianma-Gouteng-Yin (150ml tid).The western medicine (WM)group were treated with lercanidipine hydrochloride tablets(10-15mg qd). The symptoms,CBP,24hSBP,24hDBP, dSBP, dDBP, nSBP, nDBP,BPL,BPV and HR were assessed at baseline and after treatment for 4 weeks by follow-up CBPM and ABPM. The side effects from therapies were recorded.Results:(1)The clinicalcurative effect in symptoms:the total effective rate of TCM group was 95%,and the WM group was 68%(p<0.01). (2) Antihypertensive effects:On the basis of CBP, the total effective rate of TCM group was 30%,and the WM group was 50%(p<0.05);On the basis of ABP, the total effective rate of TCM group was 26%,and the WM group was 45%(p<0.05).(3)The values of 24hBP, dBP, nSBP, dBPL were declined obviously compared to baseline (151±12.45/92± 9.43vs138±13.71/86±86±8.61.153±12.56/94±10.03vs140±14.17/88±8.95? 145±17.06vs132±15.28.149±7.58/89±15.19vs142±5.74/87±4.62,154± 11.60/93±11.36vs146±14.08/89±8.13?141±16.89vs136±15.20?74±21.11/62 ±29.04vs46±30.46/44±30.00?75±20.88/58±30.62vs60±27.38/48± 32.07,al1P<0.01) in every group.The values of nDBP and nBPL were declined obviously in western medicine group(87±9.68vs80±9.10? 82±22.70/68±25.66vs61±31.06/51±27.41,P<0.01),bu they weren't declined in TCM group(83±10.08vs82±9.75?72±30.86/53±30.38vs68±30.22/50±31.97,p> 0.05).The values of 24hSBP, dSBP, sBPL were declined obviously in WM group than in TCM group(142±5.74vs138±13.71?146±14.08vs140±14.17.60±27.38vs46 ±30.46?68±30.22vs61±31.06,p<0.01). The declined of 24hDBP, dDBP, nSBP,nDBP DBPL had no obvious difference in both groups(87±4.62vs86±8.61?89 ±8.13vs88±8.95.136±15.20/82±9.75vs132±15.28/80±9.10?48±32.07vs44 ±30.00?50±31.97vs51±27.41,P>0.05).(4)There were no difference of blood pressure variability(TCM group0.10±0.03/0.12±0.03vs0.10±0.03/0.12±0.03? WM group0.10±0.04/0.11±0.03vs0.10±0.25/0.12±0.03,P>0.05) and nocturnal blood pressure drop rate(TCM group6±9.01/8±8.49vs6±5.93/8±4.60?WM group5±9.13/7±8.36vs6±7.10/8±6.60,p>0.05)after treatment for 4 weeks in both groups.(5)The heart rate was increased in WM group(72±9.46vs76±10.69,P< 0.01),but it was no change in TCM group(71±9.99vs72±10.43,P>0.05).Conclusion:It had better improving efficacy of clinical symptoms and tolerability, and less side effects in treatment of hypertension patients by fixed changing TCM of Tianma-Gouteng-Yin with common dosage or lercanidipine hydrochloride tablets with middle-small dosage especially in group of TCM. Lercanidipine tablets on systolic blood pressure depressor effect is better than that of fixed changing TCM of Tianma-Gouteng-Yin, while there are no difference in both groups by decline DBP. The antihypertensive effective rate of the two groups were lower which may be due to small dosage, lercanidipine hydrochloride tablets can increase heart rate after treatment.This study shows that office blood pressure monitoring is easy to overestimate the level of blood pressure of patients and underestimate the antihypertensive effects,while these phenomenons can be avoided by the ambulatory blood pressure monitoring. Comprehensive analysis of symptoms with CBP and ABP can effectively evaluate the clinical curative effect of drugs.