OBJECTIVE  To evaluate the efficacy of Qianyang Yuyin Granules in reducing the early renal damage and renal fibrosis in the hypertensive elderly with the syndrome of yin deficiency and yang hyperactivity based on shear wave elastography (SWE).

  METHODS  Through randomized controlled trial, we accepted 40 renal-damage cases of the hypertensive elderly with the syndrome of yin deficiency and yang hyperactivity who met the inclusion criteria. The control group was given standard treatment with angiotensin Ⅱ receptor blocker (ARB) or combined with calcium channel blocker (CCB) drugs, while the treatment group was treated with Qianyang Yuyin Granules on top of the therapy in the control group. The course of treatment lasted for 12 weeks. In addition, we observed the changes of the syndrome scores of traditional Chinese medicine (TCM), clinical efficacy, blood pressure, transforming growth factor-β1 (TGF-β1), hyaluronic acid (HA), laminin (LN), type IV collagen (IV-C), N-terminal peptide of type Ⅲ procollagen (PⅢ NP), urinary neutrophil gelatinase-associated lipid transport protein (NGAL), kidney injury molecule-1 (KIM-1), interleukin-18 (IL-18), as well as renal Young's modulus values before and after treatment.

  RESULTS  After treatment, the TCM syndrome scores of both groups were reduced (P < 0.05, P < 0.01), but the treatment group was better than the control group in relieving the symptoms of vertigo, lumbago, vexing heat in the five centers, palpitations, and total scores (P < 0.05, P < 0.01). Thus, the TCM clinical efficacy of the treatment group was better than that of the control group (P < 0.05). Besides, the systolic pressure and pulse pressure difference of the treatment group dropped (P < 0.05, P < 0.01). At the meantime, some Serum fibrosis indexes such as TGF-β1, HA, LN and PⅢ NP expression levels were significantly decreased in the treatment group (P < 0.05), whose results were better than those in the control group (P < 0.05). Likewise, urinary KIM-1 and IL-18 levels of renal tubular injury markers were significantly decreased in the treatment group (P < 0.01), whose results were better than those in the control group (P < 0.01). In addition, the Emean value of Young's modulus was significantly decreased in the treatment group (P < 0.01), whose result was better than that in the control group (P < 0.05). No evident adverse reactions were observed in the two groups during the treatment course.

  CONCLUSION  Qianyang Yuyin Granules can reduce early renal damage and renal fibrosis in elderly hypertensive patients with the syndrome of Yin deficiency and Yang hyperactivity.