Clinical Study On Early Interventional Treatment Of Hypertension With Qianyang Yuyin Granules To Improve Renal Damage

Objective:The epidemiological study and the clinical study were conducted to investigate renal damage of hypertension in the early stage.Firstly,we carried out an epidemiological study in natural population to explore the relationship between serum UMOD level and renal damage Secondly,to confirm whether Qianyang Yuyin Granules can improve the corresponding indicators of renal damage of hypertension in the early stage,we conducted a randomized parallel controlled clinical study.1.Epidemiological studyMethods:The participants'general data and serum samples of 1035 residents collected in June 2017 in the station community of Danyang city were selected for this research.The general data includes basic personal information,height,weight,BMI,personal history,past medical history,current medication status,and immediate blood pressure,etc.We detected the fasting blood glucose,renal function indicators(serum creatinine,urea nitrogen,serum uric acid,eGFR,urine mALB,UACR,etc.)and the serum UMOD level.According to the renal function,they were divided the participants into the normal renal function group and the abnormal renal function group.Statistical analysis was performed by SAS 9.4 software.Results:?563 randomly selected participants were divided into two groups according to renal function.There were 444 in the normal renal function group and 119 in the renal dysfunction group;? There were no statistical difference between two groups among gender,heart rate,smoking rate,drinking rate,blood uric acid,blood creatinine,urea nitrogen and the prevalence rate of diabetes(P?0.072).Abnormal renal function population were older than normal renal function population(+3.23 years),and had higher BMI(+0.83kg/m2),fasting blood glucose level(+0.6 mmol/L),blood pressure level(+13.1/5.85mmHg),proportion of using antihypertensive drugs(67.23%Vs 34.23%)and the prevalence rate of hypertension(42.86%Vs 19.14%),and the difference was statistically significant(P?0.003):?The eGFR(-4.38 mL/min/1.73m2)and serum UMOD level(-13.56ng/mL)were lower in patients with renal dysfunction,and the urine mALB(+103.03mg/L)and UACR(+42.87mg/g)were higher(P?0.003);?Serum UMOD level was negatively correlated with urea nitrogen and serum uric acid(P?0.018),but not with urine mALB,UACR,serum creatinine and eGFR(P?0.068);?Serum UMOD level was positively correlated with eGFR(P<0.0001)and negatively correlated with serum creatinine and urea nitrogen(P<0.011)in people with abnormal renal function,and there was no significant correlation between urine mALB,UACR,serum uric acid and serum UMOD level(P ?0.172)Conclusions:In natural population,serum UMOD level in patients with renal dysfunction was lower than that in normal renal function population.Serum UMOD level can reflect renal function to a certain degree,but its diagnostic value for early renal damage needs further research2.Clinical studyMethods:140 essential hypertensive patients without clear renal damage were randomly divided into the experimental group and the control group at the ratio of 1:1.The control group used lifestyle intervention plus standard antihypertensive treatment(based on ACEI or ARB,can be combined with other antihypertensive drugs)after the blood pressure was under the standard level.The experimental group was given Qianyang Yuyin Granules on the basis of the control group's treatment.The TCM symptom score,TCM clinical efficacy,clinic blood pressure level,urine mALB,UACR,eGFR,serum NGAL level and serum UMOD level were detected after 1 year.Statistical analysis was performed by SPSS 21.0 softwareResults:? Finally,135 subjects including 67 in the experimental group and 68 in the control group were included;? There was no statistical difference between the two groups among the gender,disease course,weight,height,waist,and blood pressure(P?0.402).However,there was statistical difference in age(P=0.011);?There was no statistical difference in total TCM symptom scores and TCM clinical efficacy between two groups after 1 year(P?0.27),but there was significant statistical difference between before and after treatment in each group(P<0.0001);? There was no significant difference between the two groups in improving TCM main symptom scores(P?0.05).The experimental group was better than the control group in improving dry mouth(P=0.024).However,there was no statistical difference in other secondary symptom scores between two groups after the treatment(P?0.083);?The systolic and diastolic blood pressure had no significant difference between two groups after the treatment(P?0.097);? After 1 year,there was no significant difference between two groups among the level of urine mALB,UACR,eGFR,and serum UMOD(P?0.117).The improvement of serum NGAL level in the experimental group was better than that in the control group(P=0.038);?There was no significant statistical difference between before and after treatment in each group among these renal biomarkers 0.904),except for the urine mALB and serum UMOD level(P?0.033).Conclusions:After one year of intervention based on the blood pressure control,Qian yang Yuyin Granules can improve several TCM symptoms and serum NGAL level.