Effect of yanggan qinggan pinggan technique on the changes of blood pressure and angiotensin Ⅱ in patients with primary hypertension

Xinyu CHEN; Yuemei LIU; Haibo XIE; Bin YU; Xiaobing XIE

ABSTRACT

BACKGROUND:

Early clinical researches suggest that mediodespidine capsule can decrease blood pressure of patients with primary hypertension on the basis of yanggan qinggan pinggan technique.

OBJECTIVE:

To observe the effect of mediodespidine capsule on primary hypertension and angiotensin Ⅱ (Ang- Ⅱ ) of patients in the types of yin deficiency, yang excess and liver fire.

DESIGN:

Randomized controlled case observation.

SETTING:

Department of Cardiology, First Affiliated Hospital, Hunan University of Traditional Chinese Medicine.

PARTICIPANTS:

Patients were selected from the Inpatient Department and Out-patients Clinic of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine between April 1999 and April 2000. Inclusion criteria Patients, who were diagnosed with the criteria of primary hypertension, who belonged to the types of yin deficiency, yang excess and liver fire, who could endure this test, who were coincidence with the criteria of mental-stress test, were all consent. Exclusion criteria Patients who had severe congestive heart failure, atrophic arthritis and unable tolerance were excluded. There were 60 cases in total, including 29 males and 31females. All patients were divided into mediodespidine group and verapamil group with 30 in each group on the basis of randomly digital table.

METHODS:

Patients who had positive results of awaken mental-stress test were involved in this study. Cases in mediodespidine group were treated with mediodespidine capsule, which was made of tall gastrodia tuber, spine date seed and fourstamen stephania root at the dosage of 0.43 g/pill and were provided by the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine (wei yao ji zi 05-047, batch number 990503), five pills each for 3 times a day. Cases in verapamil group were treatedwith verapamil (40 mg/pill, Shanghai Huanghe Liya PharmaceuticalCompany Limited,batch number 980301B) 80 mg each for 3 times a day. The course in both groups was 4 weeks. ① Effect of blood pressure Average value of blood pressure tested for 3 successive days were regarded as the blood pressure before treatment, and average value of blood pressure tested for 3 times after treatment was regarded as the blood pressure after treatment. ② Effect of symptomScores were recorded as four levels according to main symptoms, such as vertigo, headache, pain and weakness of waist and knees, before and after treatment. ③ Values of Ang- Ⅱ were measured with radioimmunoassay before and after cold pressor test. Effect on Ang- Ⅱ was evaluated with effect of decompression, effect of clinical symptom and criteria of clinical effect.MAIN OUTCOME MEARUSES Clinical symptoms, values of blood pressure, heart rate and Ang- Ⅱ before and after cold pressor test.

RESULTS:

A total of 60 patients with primary hypertension were involved into the final analysis.① Totally effective rate of clinical symptoms of patients in mediodespidine group was higher than that of patients in verapamil group, but the effect of decompression was not significant between the two groups (P ＞ 0.05). ② There was remarkably significant difference of heart rate in both groups before and after treatment (P ＜ 0.01), especially the decrease in verapamil group was great, and there was significant difference (P ＜ 0.05). ③ Values of systolic pressure and diastolic pressure were decreased in both groups after cold pressor test (P ＜ 0.01), but there was no significant difference between the two groups (P ＞ 0.05). ④ There was no significant difference in clinical effect between the twogroups (P ＞ 0.05).⑤ After treatment, concentration of Ang- Ⅱ at basic level in both groups was decreased, and there was significant difference between them (P ＜ 0.01);concentration of Aug-Ⅱ was decreased in both groups after cold pressor test as compared with that before treatment, but there was no significant difference between them (P ＞ 0.05).

CONCLUSION:

Mediodespidine capsule can decrease blood pressure stably, and the effect is stronger than that of verapamil at the aspect of decompression and improving symptoms. Blood pressure of patients with primary hypertension in the types of yin deficiency and yang excess or liver fire can be decreased by decreasing the level of plasma Ang-Ⅱ to a certain degree.