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Objective: analysis of the phlegm hypertension patients blood pressure mediated brachial artery endothelium-dependent vasodilation (FMD) and carotid artery - media thickness (IMT) with multiple parameters observed Wendan piece of sputum improve the role of the turbidity of hypertension in patients with vascular endothelial dysfunction, and to explore the possible mechanism Turbid Wendan treatment of endothelial dysfunction. Methods: 42 cases of phlegm hypertensive patients grouped by simple random method Wendan tablets in the treatment group (22 cases), including 10 males and 12 females, aged 41-60 years old, mean age 48.9 ± 5.96 years, with an average duration of 4.68 ± 3.01 years; placebo control group of 20 patients, including 11 males and 9 females, age 40-60 years, mean age 49.5 ± 6.33 years, the average duration of 4.60 ± 3.38 years. The two groups of patients are ammonia amlodipine (Norvasc, 5mg / tablets by Pfizer) based antihypertensive drugs, 5-15mg / 1 /. Effective control of blood pressure (systolic blood pressure ≤ 140mmHg, diastolic blood pressure ≤ 90mmHg) on ??the basis of the treatment group with Wendan piece, plus the control group with placebo. Wendan piece usage: 3 / times 3 times / day in March, as a course of treatment to six months. Placebo provided by the Guangzhou University of Chinese Medicine, the First Affiliated Hospital of Pharmacy, the usage Wendan piece with. Enrolled patients before and after treatment symptom scores were collected and measured lipid levels, peripheral blood endothelial cell relaxing factor (NO) and endothelin (ET-1) levels; using color Doppler ultrasound measurements before and after treatment in patients with bilateral carotid IMT thickness plaque size, blood pressure mediated brachial artery endothelium-dependent vasodilation (FMD) and nitroglycerin-mediated endothelium-dependent vasodilation (NID). Results: 1. Correlation analysis showed that FMD only with TG significant correlation (r = 0.436, p lt; 0.01); IMT and SBP, and NO/ET-1 value correlation with the total score of the PP, plaque the, soft plaque score, symptom scores, TC level was significantly correlated (p lt; 0.01), with HDL-C was a significant negative correlation (r = -0.674, p lt; 0.01), multiple linear regression analysis TCM symptoms with HDL-C greater impact on IMT regression equation for IMT = 1.296 0.032 × TCM syndrome integral to -0.289 × HDL-C (R-2 = 0.650, p lt; 0.05). 2 the piece group FMD Wendan after treatment significantly improved (p lt; 0.01), and better than the placebo control group (7.82 ± 2.12 vs6.04 ± 3.02%, P = 0.032). Brachial artery diameter and NID was no significant difference between the two groups (p gt; 0.05). 3 after treatment Wendan slice thickness of carotid IMT significantly improved with a statistically significant difference in the placebo group (1.16 ± 0.15 vs1.34 ± 0.14mm, p lt; 0.01); their total plaque score, soft plaque integral and hard plaque score than before treatment decreased significantly (p lt; 0.01), but no statistically significant difference between the control group. 4. Patients with Wendan piece group after treatment, peripheral blood NO concentration of 47.01 ± 0.18μmol / L, significant improvement than before treatment, compared with control group statistically significant difference (p = 0.013); After treatment, ET-1 were reduced, respectively, with a statistically significant difference (p lt; 0.05) before treatment, but no significant difference between the two groups (70.48 ± 13.19vs71.16 ± 12.73 Pg / L, p gt; 0.05). The the treatment after Wendan piece group NO/ET-1 ratio than in the placebo control group was significantly increased (p lt; 0.01). TC, TG, LDL-C water after the treatment of the patients dropped by an average HDL-C levels, but no statistically significant difference (p gt; 0.05) compared with before treatment; compared with the control group, Wendan piece more obvious treatment group TC levels (4.42 ± 0.77 vs4.96 ± 0.79mmol / L, p = 0.029), HDL-C level was significantly increased (1.22 ± 0.23vs1.06 ± 0.26 mmol / L, p = 0.041) . Than before treatment after 6 months of treatment, the Wendan piece group TCM symptoms total score decreased significantly (p lt; 0.01), compared with the control group, a statistically significant difference (p lt; 0.01). Symptom scores, Wendan tablets in the treatment group were dizziness, headache, chest tightness, vomiting phlegm extension, palpitations, insomnia, and symptoms of eating less than before treatment (p lt; 0.05) significantly improved the treatment group and Wendan piece vertigo headache and insomnia symptoms improve significantly better than the control group (p lt; 0.05). Conclusion: 1. Hypertensive patients FMD decreased low concentration of NO, ET-1 is relatively higher, prompt the phlegm hypertension in patients with significant vascular endothelial dysfunction. No significant correlation between FMD and hypertension multiple indicators, while IMT is closely related with the clinical symptoms, plaque score, and lipid levels, to infer, FMD can reflect the presence of endothelial dysfunction, but the degree of impairment and disease The risk assessment is less good than the IMT, a combination of the two can better reflect the degree of hypertension vascular lesions, more predictive significance for the development of the disease. 2. After the Wendan tablets in treatment can significantly improve endothelial-dependent vasodilation, reducing the thickness of the carotid IMT and plaque score, correct NO and ET-1 levels, at the same time, it can significantly improve the clinical symptoms in patients with hypertension and regulate blood lipids level. These conclusions suggest that the Turbid Wendan can be righting exorcism, the good endothelial dysfunction, slow down and reverse the artery atherosclerotic process role.
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