Objective To observe the clinical efficacy of modified Zexie Decoction in treatment of elderly patients with grade 1 of essential hypertension (extremely high risk) differentiated as syndrome of excessive phlegm and dampness.

Methods From May 2021 to April 2023, 103 elderly patients with grade 1 of essential hypertension (extremely high risk) in the Department of Geriatric Diseases in the authors' hospital were selected as research objects, and they were randomly divided into control group (n=51) and study group (n=52). The control group received lifestyle interventions, while the study group was treated with modified Zexie Decoction on the basis of the control group. After two weeks of treatment, the clinical efficacy, the score of traditional Chinese medicine symptoms, blood pressure, blood lipid level, and maximum intima-media thickness of the carotid artery (d_IMTmax) were compared between the two groups.

Results The total effective rate in the study group was 90.38 %, which was significantly higher than 56.86 % in the control group (P < 0.05). After treatment, the scores of primary and secondary symptoms in both groups decreased significantly when compared to those before treatment, and the scores of primary and secondary symptoms in the study group were significantly lower than those in the control group (P < 0.05). After treatment, the systolic and diastolic blood pressures in both groups decreased significantly when compared to those before treatment, and the systolic and diastolic blood pressures in the study group were significantly lower than those in the control group (P < 0.05). After treatment, the levels of total cholesterol, triglycerides and low-density lipoprotein cholesterol decreased significantly in both groups, while high-density lipoprotein cholesterol level increased significantly, and the levels of total cholesterol, triglycerides and low-density lipoprotein cholesterol in the study group were significantly lower than those in the control group, but the high-density lipoprotein cholesterol level was significantly higher than that in the control group (P < 0.05). After treatment, the d_IMTmax in the treatment group was (0.92±0.12) mm, which was significantly less than (1.10±0.15) mm in the control group (P < 0.05).

Conclusion Modified Zexie Decoction can effectively improve clinical symptoms in elderly patients with essential hypertension, regulate blood pressure and lipid levels, alleviate vascular endothelial injury, and reduce the carotid intima-media thickness.