| Background and Objective:Obesity-related hypertension has been linked to higher blood pressure variability(BPV),which is thought to be one of the main contributors for aggravating target organ damage and increasing cadiovascular mortality.Qing Gan Zi Shen Tang(QGZST)has been used in clinical practice for many years.Its effect of lowering blood pressure and improving metabolisn have been confirmed by early basic studies,but its intervention on BPV has not been involved.This clinical study,supported by key research and development plan of science and technology in Jiangsu Province(BE2017775),applies QGZST to obesity-related hypertensive patients with western medicine controlling blood pressure up to the standard,and evaluates its improvement effect on BPV and syndrome scores of traditional Chinese medicine,providing certain research basis for promoting stable blood pressure reduction by traditional Chinese medicine.Methods:All the cases were selected from September 2018 to January 2020,patients who were treated in the department of cardiology,the institue of hypertension and the ward of the department of cardiology of the affiliated hospital of Nanjing University of Traditional Chinese Medicine and diagnosed as obesity-ralated hypertension,which were consistent with liver-yang hyperactivity or yin deficiency and yang hyperactivity.The patients included in the study were divided into an experimental group and a control group,each with 25 patients.Both groups were treated with calcium channel blocker(CCB)combined with angiotensin receptor antagonist(ARB)(amlodipine benzenesulfonate tablet and valsartan capsule)to control blood pressure to reach the standard.On this basis,the experimental group was applied QGZST.Both groups were treated for 6 months,and ambulate blood pressure monitoring was conducted on the patients at the initial diagnosis and 6 months after treatment,respectively,to observe the changes ofBPV?TCM syndrome scores?mean blood pressure?metabolic index and safety index of the patients in the two groups.Results:Main outcome index(BPV index):After treatment,compared with the control group,the decrease of standard deviation of morning diastolic blood pressure(MSDD)and coefficient of variation of morning diastolic blood pressure(MSBP-CV)in the experimental group was statistically significant(p<0.05).Compared with the control group,Si Shi(9-llam)standard deviation of systolic blood pressure(SDS)?Si Shi(9-llam)coefficient of variation of systolic blood pressure(SBP-CV)?Shen Shi(3-5pm)standard deviation of systolic blood pressure(SDS)?Shen Shi(3-5pm)coefficient of variation of systolic blood pressure(SBP-CV)?Wu Shi(llam-lpm)standard deviation of diastolic blood pressure(SDD)?Si Shi(9-11 am)coefficient of variation of diastolic blood pressure(DBP-CV)?Wu Shi(llam-lpm)coefficient of variation of diastolic blood pressure(DBP-CV)decrease in the experimental group with statistical significance(p<0.05).Secondary outcome index:?TCM syndromes scores:After treatment,both the experimental group and the control group are significant improved(p<0.01).there is no statistically significant difference between the two groups.(p>0.05).?Mean blood pressure index:After treament,there is no significant difference in mean blood pressure between the experimental group and the control group at any time(p>0.05).?Glucose and lipid metabolism indexs:After treament,the improvement of HbAlc in the experimental group and the control group is statistically significant(p<0.01),but no significant improvement is observed in the other indexs.And the difference between the two groups is not statistically significant(p>0.05).?Blood pressure circadian rhythm:There is no statistically significant difference between the experimental group and the control group in restoring the circadian rhythm of obesity-related hypertensive patients(p>0.05).Conclusion:QGZST has a tendency to improve BPV to a certain extent,which may promote further stable blood pressure reduction in obesity-related hypertensive patients. |
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