The Contrast Evaluation By Office Blood Pressure,ambulatory Blood Pressure Mornitoring And Study On Dose-response Relationship In Patients With Primary Hypertension Of Yinxu-Yangkang Type Treated By Fixed Changing Tcm Of Tianma-Gouteng-Yin

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.To study on dose-response relationship of different doses.Methods: Total of 84 patients with essential hypertension of Yinxu-Yangkang type were randomly divided into two groups of each 42 cases.treatment group were treated with fixed changing TCM of Tianma-Gouteng-Yinand of one dose per day which take it divided into three times a day,control group were treated with fixed changing TCM of Tianma-Gouteng-Yin of one half of dose per day which take it divided into three times a day.The symptoms,CBP,24 hSBP,24hDBP,dSBP,dDBP,nSBP,nDBP,BPL,BPV and HR were assessed at baseline and after treatment for 4weeks in each group.The dose-response relationship between two groups were compared.The side effects from therapies were recorded.Results:(1)The clinicalcurative effect in symptoms: the clinical symptoms in the two groups were relieved,but that of the treatment group was more significant(p<0.05).(2)Effects in casual blood pressure:Casual blood pressure levels of SBP and DBP were insignificant reduced compared to baseline in two groups repectively(all p>0.05).(3)The change of Mean value of ABP :In the treatment group,The values of 24hBP(148 ± 11.24/93 ± 8.82vs142 ± 13.05/90 ± 9.32),dBP(150 ± 11.01/94 ±8.96vs144 ± 13.98/91 ± 10.07),nBP(141 ± 14.01/87 ± 9.09vs137 ± 12.51/84 ±8.66)were declined obviously compared to baseline(all p<0.05).In the control group,The values of 24hBP(149±12.26/91±9.09vs144±12.34/88±12.53),dBP(152±11.82/93±10.09vs147±12.14/90±12.96),nSBP(139±15.92vs135±15.14)were all declined obviously compared to baseline(all p<0.05),but The values of nDBP(84±10.48vs81 ± 12.43)were no obvious declined compared to baseline(p > 0.05).The values of 24 hBP,dBP,nBP were no obvious difference in two groups(all p>0.05).(4)Comparison of blood pressure load(BPL): Compared with before treatment,thedSBPL of treatment group was significantly lower(71±23.05vs54±29.26,P<0.01),The declined of dDBPL(64±29.97vs58±31.15),nBPL(81±22.60/70±26.64vs75±23.65/71± 27.04)had no obvious difference in treatment group(all P > 0.05).The values of dBPL was declined obviously in control group(74±21.65/61±27.61vs62±25.25/52±31.57,p<0.05),The declined of nBPL(72±29.74/58±28.71vs68±29.89/53±32.08)had no obvious difference in control group(all P>0.05).The values of BPL were no obvious difference in two groups(all p > 0.05).(5)Comparison of blood pressure variation(BPV):Compared with before treatment,the BPV of treatment group was higher(0.09±0.03/0.10±0.02vs0.11±0.04/0.12±0.04、0.09±0.03/0.10±0.02vs0.11±0.04/0.12±0.04,P<0.05).There was no difference of blood pressure variation in control group(0.11±0.03/0.12±0.04vs0.11±0.03/0.12±0.03、0.10±0.03/0.13±0.06vs0.09±0.03/0.13±0.04,p>0.05).(6)The nocturnal blood pressure drop rate after treatment for 4 weeks in two groups were not changed(all p>0.05).(7)Comparison of pulse pressure(PP):The values of 24 PP,dPP,nPP were all declined obviously compared to baseline in two groups(all p<0.05).(8)Comparison of mean arterial pressure(MAP):The values of 24 MAP,dMAP,nMAP were all declined obviously compared to baseline in two groups(all p < 0.01).(9)Comparison of the heart rate:In the treatment group,The values of 24hHR(71±6.57vs73±6.18),dHR(76±3.38vs77±2.42),nHR(64±2.39vs65±2.35)were obvious increased compared to baseline(all p <0.01);In the control group,The values of 24hHR(71 ±6.22vs72 ±7.21),dHR(75 ± 2.91vs77 ± 3.04)were all increased obviously compared to baseline(all p<0.05),but the values of nHR(64±2.74vs63±2.49)were no obvious declined compared to baseline(p>0.05);Comparison between two groups,The values of 24 hHR,dHR,nHR were no obvious difference in two groups(all p>0.05).(10)No serious side reactions were observed during the treatment in two groups.Conclusion:(1)The clinical symptoms of Yinxu Yangkang type of primary hypertensives can be relieved obviously by one dose per day or one half of dose per day of fixed changing TCM of Tianma-GoutengYin,but group of one dose per day was more significant.(2)CBP levels were insignificant reduced compared to baseline in two groups repectively.That two kinds of doses are not able to improve the patient’swhite coat effect and be short of dose-response relationship.(3)The average ambulatory blood pressure and blood pressure load etc.can be reduced by both two kinds of doses of TCM.The concentration-response relationship in group of one dose per day are mainly better than group of one half of dose per day on improving of clinical symptoms,decreasing of nocturnal diastolic blood pressure rather than other indicators,but it slightly increases coefficient of variation of blood pressure and heart rate.