The Influence Of Modified Erzhi Pill On Insulin Resistance In Postmenopausal Women With Hypertension

ObjectiveTo investigate the clinical efficacy of modified Erzhi Pill(MEP)in the treatment of postmenopausal women with hypertension and the effection insulin resistance(IR).MethodsIt was a randomized prospective trial.Both fasting blood-glucose(FBG)and fasting insulin(FINS)were tested and then insulin resistance index(IRI)was calculated to screen for sixty-five cases of naturally-postmenopausal patients who suffered from hypertension associated with insulin resistance in in-patient and out-patient department of cardiovascular in the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from August 2015 to February 2016.They were randomly divided into a treatment group with thirty-one casesand a control group with thirty-four cases by the single-blind randomized method.In the control group,patients with stage 1 hypertension took Levamlodipine Besylate to control blood pressure.Patients of this group with stage 2 hypertension were treated with Amlodipine Besylate tablets or Nifedipine controlled realease tablets.While all patients of the treatment group received oral MEP granule based on the conventional western medicine therapy as control group.Observed the clinical efficacy by filling in the symptomatic grading and quantifying standards before and after the treatment.Tested both FBG with glucose oxidase method and FINS with electrochemiluminescence determination and then worked out HOMA2-IR by HOMA-2 calculator 2.2.3v software to estimate IR before and after trial.Also compare the change of IR index between the tpye of asthenia of both yin and yang and the others,including overabundant liver-fire syndrome,type of excessive accumulation of phlegm-dampness,yin-deficiency and yang-excess type.All experimental data were processed by SPSS 17.0 software.The measurement data were expressed by the mean and standard deviation,and they were compared with the paired t test both within group and between groups.Theconstituent ratio and rate of count data between the groups as well as before and after treatment were compared with the the Chi square test.While the grading information were compared with rank sum test.Moreover,if P was less than 0.05,it meaned statistically significant difference.Results1.Before theintervention,there was no statistically significant difference(P>0.05)between patients of two groups in age,duration of menopause,duration of hypertension,body mass index(BMI),impaired glucose regulation(IGR)and IR index,which signified that two groups above were comparable.During the trial,no case of both groups fell off.2.Hypertension symptoms:afterthe intervention of 4 weeks,the symptomatic grading and quantifying score decreased and the therapeutic index increased in the treatment group with statistically significant difference(P<0.05)compared with the control group.3.IR index:after the intervention of 4 weeks,compared with the control group,there was no significant differences in the level of HOMA2-IR in the treatment group(P>0.05)but those of syndrome of deficiency of both yin and yang.Conclusion1.MEP could improve their hypertension symptoms,and it suggested that tonifying the kidney could be as the basis treatment of postmenopausal hypertension.2.IR existed in hypertension among various types,and MEP could only improve IR in patients with tpye of asthenia of both yin and yang rather than other types.It speculated that tonifying the kidney was applicable to improve IR in patients with syndrome of deficiency of both yin and yang.