Therapeutic Evaluation Of The Jia Wei Tian Ma Gou Teng Prescription For The Hypertensive Patients In The Community:Microalbuminuria Study

Objective: Objective to evaluate the effect of modified Tianma Tianma Decoction on the blood pressure of patients with hypertension,and to study the effect of modified Tianma Tianma Decoction on microalbuminuria in patients with hypertension.Methods: A multi center clinical trial of the entry,45 to 79 years old,1 hypertension grade 2 or isolated community subjects,syndromes stratified to select qualified cases,and this is a randomized method based on randomized double-blind controlled study.All standardized treatment,lifestyle changes,outpatient health education,and care for the benefit of the patient.According to the introduction period of 2 weeks,double-blind treatment for 24 weeks,follow-up period of 12 months of treatment,and fill in the study of medical records.The test group were treated with traditional Chinese medicine non drug treatment + jiaweitianmagoutengyin Decoction Treatment Granules Combined with symptomatic treatment + step-down,control group with non drug therapy plus traditional Chinese medicine placebo granules therapy and antihypertensive therapy.All of the subjects in the 0 week(visit 2),after 12 weeks of medication(visit 8),after 24 weeks of medication(visit 11)detect the right upper seat of brachial artery measuring blood pressure and physical examination,UACR,blood routine,blood biochemistry,ECG,24 H ambulatory blood pressure etc..All the medical records were input into electronic CRF,and a special database for diagnosis and treatment was set up and entrusted to the third party data management.The curative effect index was analyzed by data.The changes of urinary protein / urine creatinine ratio,systolic blood pressure,pulse pressure and diastolic blood pressure were observed before and after treatment in the two groups.Results: Compared with the experimental group,the control group has statistical significance.The change of systolic blood pressure in the analysis of the blood pressure(brachial artery systolic pressure)in the consulting room was analyzed.During the test,the decrease trend of SBP in the control group and the experimental group was obvious.At 12 weeks and 24 weeks,the difference between the two groups was statistically significant(P<0.05).Diastolic blood pressure changes: both the control group and the experimental group DBP showed a downward trend,and the downward trend was not obvious.There was no significant difference between the 2 groups at 12 weeks and 24 weeks(P>0.05).Pulse pressure changes: both the control group and the experimental group showed a downward trend in pulse pressure.At 12 weeks,the P value between the 2 groups was greater than 0.05,indicating that there was no significant difference between the 2 groups.At 24 weeks,the P value between the two groups was less than 0.05,suggesting that there was significant difference between the 2 groups.The general change of ambulatory blood pressure monitoring is the same as that in consulting room.The standard rate of systolic blood pressure and pulse pressure treatment in the control group and the experimental group were 42.86% and 76.41% respectively,and the P value of the two groups was less than 0.05,and there was significant difference in the rate of reaching the standard.The effective rate of systolic blood pressure treatment in the control group and the experimental group was 39.56% and 78.97% respectively,and the P value of the two groups was less than 0.05,and there was a statistically significant difference in the effective rate.After 24 weeks treatment,the urine protein / urine creatinine in the control group dropped to about 0.30,and the control group dropped to about 0.20.The experimental group and the control group had significant difference(P<0.05).The incidence of adverse events in the control group and the experimental group were 0.55% and 0.51% respectively.There was no significant difference between the 2 groups by chi square test(P > 0.05).Conclusion: For the treatment of isolated systolic hypertension in community patients,compared with the control group with simple western medicine antihypertensive drug test group comprehensive antihypertensive therapy in jiaweitianmagoutengyin Decoction on the basis of the comprehensive therapy of jiaweitianmagoutengyin Decoction in reducing systolic hypertension in patients with systolic blood pressure and urine protein / urine creatinine value advantage is obvious in treatment.Reduce the patients with microalbuminuria were better.But there is no obvious advantage in reducing diastolic blood pressure.In the long term,there is a therapeutic advantage in reducing pulse pressure in patients with isolated systolic hypertension.It also has obvious therapeutic advantages to improve the systolic blood pressure,pulse pressure,the standard of treatment and the effective rate of systolic blood pressure treatment.Adverse events comprehensive antihypertensive therapy and Western medicine therapy of jiaweitianmagoutengyin Decoction based on the incidence rate was low,the security is high,integrated traditional Chinese medicine antihypertensive scheme of jiaweitianmagoutengyin Decoction based on the incidence of adverse events in the treatment of no obvious advantage to reduce.