Sotos syndrome is characterized by overgrowth features and is caused by alterations in the nuclear receptor binding SET domain protein 1 gene.Attentiondeficit/hyperactivity disorder(ADHD)is considered a neurodevelopme...Sotos syndrome is characterized by overgrowth features and is caused by alterations in the nuclear receptor binding SET domain protein 1 gene.Attentiondeficit/hyperactivity disorder(ADHD)is considered a neurodevelopment and psychiatric disorder in childhood.Genetic characteristics and clinical presentation could play an important role in the diagnosis of Sotos syndrome and ADHD.Magnetic resonance imaging(MRI)has been used to assess medical images in Sotos syndrome and ADHD.The images process is considered to display in MRI while wavelet fusion has been used to integrate distinct images for achieving more complete information in single image in this editorial.In the future,genetic mechanisms and artificial intelligence related to medical images could be used in the clinical diagnosis of Sotos syndrome and ADHD.展开更多
BACKGROUND Sotos syndrome is an autosomal dominant disorder,whereas attention-deficit/hyperactivity disorder(ADHD)is a neurodevelopmental condition.This report aimed to summarize the clinical and genetic features of a...BACKGROUND Sotos syndrome is an autosomal dominant disorder,whereas attention-deficit/hyperactivity disorder(ADHD)is a neurodevelopmental condition.This report aimed to summarize the clinical and genetic features of a pediatric case of Soros syndrome and ADHD in a child exhibiting precocious puberty.CASE SUMMARY The patient presented with accelerated growth and advanced skeletal maturation;however,she lacked any distinct facial characteristics related to specific genetic disorders.Genetic analyses revealed a paternally inherited heterozygous synonymous mutation[c.4605C>T(p.Arg1535Arg)].Functional analyses suggested that this mutation may disrupt splicing,and bioinformatics analyses predicted that this mutation was likely pathogenic.After an initial diagnosis of Sotos syndrome,the patient was diagnosed with ADHD during the follow-up period at the age of 8 years and 7 months.CONCLUSION The potential for comorbid ADHD in Sotos syndrome patients should be considered to avoid the risk of a missed diagnosis.展开更多
Tourette syndrome(TS) is a neurodevelopmental disorder characterized by multiple chronic motor and vocal tics beginning in childhood. Several studies describe the association between TS and attention deficit hyperacti...Tourette syndrome(TS) is a neurodevelopmental disorder characterized by multiple chronic motor and vocal tics beginning in childhood. Several studies describe the association between TS and attention deficit hyperactivity disorder(ADHD). Fifty percent of children diagnosed with ADHD have comorbid tic disorder. ADHD related symptoms have been reported in 35% to 90% of children with TS. Since ADHD is the most prevalent comorbid condition with TS and those with concomitant TS and ADHD present with considerable psychosocial and behavioral impairments, it is essential for clinicians to be familiar with these diagnoses and their management. This paper highlights the association between treating ADHD with stimulants and the development of tic disorders. The two cases discussed underscore the fact that children with TS may present with ADHD symptomatology prior to the appearance of any TS related symptoms. Appropriate management of TS in a patient diagnosed with ADHD can lead to quality of life improvements and a reduction in psychosocial impairments.展开更多
Attention deficit hyperactivity disorder(ADHD) is the most common neurodevelopmental disorder in children and adolescents, with prevalence ranging between 5% and 12% in the developed countries. Tic disorders(TD) are c...Attention deficit hyperactivity disorder(ADHD) is the most common neurodevelopmental disorder in children and adolescents, with prevalence ranging between 5% and 12% in the developed countries. Tic disorders(TD) are common co-morbidities in paediatric ADHD patients with or without pharmacotherapy treatment. There has been conflicting evidence of the role of psychostimulants in either precipitating or exacerbating TDs in ADHD patients. We carried out a literature review relating to the management of TDs in children and adolescents with ADHD through a comprehensive search of MEDLINE, EMBASE, CINAHL and Cochrane databases. No quantitative synthesis(meta-analysis) was deemed appropriate. Metaanalysis of controlled trials does not support an association between new onset or worsening of tics and normal doses of psychostimulant use. Supratherapeutic doses of dextroamphetamine have been shown to exacerbate TD. Most tics are mild or moderate and respond to psychoeducation and behavioural management. Level A evidence support the use of alpha adrenergic agonists, including Clonidine and Guanfacine, reuptake noradrenenaline inhibitors(Atomoxetine) and stimulants(Methylphenidate and Dexamphetamines) for the treatment of Tics and comorbid ADHD. Priority should be given to the management of co-morbid Tourette's syndrome(TS) or severely disabling tics in children and adolescents with ADHD. Severe TDs may require antipsychotic treatment. Antipsychotics, especially Aripiprazole, are safe and effective treatment for TS or severe Tics, but they only moderately control the co-occurring ADHD symptomatology. Short vignettes of different common clinical scenarios are presented to help clinicians determine the most appropriate treatment to consider in each patient presenting with ADHD and co-morbid TDs.展开更多
Objective: To construct gene co-occurrence network of hypertension and liver-fire hyperactivity syndrome, to investigate the biological basis of hypertension and liver-fire hyperactivity syndrome and the characteristi...Objective: To construct gene co-occurrence network of hypertension and liver-fire hyperactivity syndrome, to investigate the biological basis of hypertension and liver-fire hyperactivity syndrome and the characteristics of the molecular network from gene level.Materials and Methods: Applying Gen CLip 2.0 online platform to retrieve the up-to-date literature referred to essential hypertension from PubMed database, cluster the abnormal expression of essential hypertension-related genes and analyze their function, combining Kyoto encyclopedia of genes and genomes-pathway analysis to investigate the closely related genes and the signaling molecules.Based on the genes closely related to hypertension, standard diagnostic symptoms of liver-fire hyperactivity were used as keywords to conduct hypertension liver-fire hyperactivity-related gene cluster analysis.Results: The top 1000 genes of essential hypertension were retrieved from GenCLip 2.0 online platform, which mainly clustered in the regulation of ambulatory blood pressure, regulation of renin-angiotensin-aldosterone system(RAAS), and sympathetic nervous system activity, as well as endothelial dysfunction; the closely related genes of hypertension with liver-fire hyperactivity are related to RAAS, gene REN, angiotensin converting enzyme, angiotensinogen, and cytochrome P450 family CYP2D6.Conclusion: A combination of literature mining and data mining can construct the gene network of hypertension and the syndrome-related genes, which provides a new method for the study of the biological basis of hypertension from the genetic level.展开更多
目的:观察耳尖放血联合天麻钩藤饮治疗肝阳上亢型高血压的临床疗效。方法:选取2022年1月至2024年1月河南中医药大学第一附属医院收治的150例肝阳上亢型高血压患者为研究对象,按照随机数字表法分为对照组和观察组,每组各75例。两组患者...目的:观察耳尖放血联合天麻钩藤饮治疗肝阳上亢型高血压的临床疗效。方法:选取2022年1月至2024年1月河南中医药大学第一附属医院收治的150例肝阳上亢型高血压患者为研究对象,按照随机数字表法分为对照组和观察组,每组各75例。两组患者均给予硝苯地平控释片,对照组给予天麻钩藤饮,观察组在对照组治疗的基础上联合耳尖放血治疗。比较两组患者临床疗效、不良反应发生情况及治疗前后中医证候积分、血压情况、生活质量评分、肾功能指标[尿微量白蛋白(microalbuminuria,MAU)、尿肌酐清除率、尿微量白蛋白与肌酐比值(albumin creatinine ratio,ACR)]。结果:治疗后,观察组中医证候积分分别为:头晕目眩(1.15±0.13)分、面红目赤(1.31±0.16)分、急躁易怒(1.50±0.20)分、口苦口干(1.39±0.27)分,总分(5.31±0.64)分,均低于本组治疗前及对照组治疗后,差异具有统计学意义(P<0.05)。观察组有效率为98.67%,高于对照组的76.00%,差异具有统计学意义(P<0.05)。治疗后,观察组患者收缩压(136.58±11.26) mm Hg,舒张压(85.91±5.40) mm Hg,24 h收缩压(136.67±9.46) mm Hg,24 h舒张压(81.62±5.13) mm Hg,下降幅度均显著高于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组生活质量评分分别为:生理机能(75.79±5.82)分、生理职能(73.18±0.55)分、躯体疼痛(72.42±6.43)分、一般健康状况(59.57±4.59)分、精力(64.58±5.57)分、社会功能(66.48±5.65)分、情感职能(75.85±4.38)分、精神健康(66.82±5.29)分,高于本组治疗前及对照组治疗后,差异具有统计学意义(P<0.05)。治疗后,观察组MAU为(20.56±4.43)μg·g^(-1),尿肌酐清除率为(1.89±0.46) g·24 h^(-1)、ACR为(10.29±2.69),低于本组治疗前及对照组治疗后,差异具有统计学意义(P<0.05)。观察组不良反应发生率为5.33%,低于对照组的18.67%,差异具有统计学意义(P<0.05)。结论:耳尖放血联合天麻钩藤饮治疗肝阳上亢型高血压,临床疗效确切,能够显著降低中医证候积分,稳定血压,改善肾功能及生活质量,且不良反应发生率较低。展开更多
目的:基于R语言初步探讨儿童抽动障碍(TD)合并注意缺陷多动障碍(ADHD)的证型证素及中医用药规律。方法:计算机检索CNKI、万方、维普、CBM、PubMed、the Cochrane Library、EMBase、Web of Science等数据中建库至2023年11月10日收录的所...目的:基于R语言初步探讨儿童抽动障碍(TD)合并注意缺陷多动障碍(ADHD)的证型证素及中医用药规律。方法:计算机检索CNKI、万方、维普、CBM、PubMed、the Cochrane Library、EMBase、Web of Science等数据中建库至2023年11月10日收录的所有中医药治疗TD合并ADHD的文献,采用Excel软件筛选文献,对证型证素及中药规范化整理后,建立数据库,运用R语言及RStudio软件进行相应的数据挖掘,包括关联分析和聚类分析,探索儿童TD合并ADHD证型证素分布及中药分布规律。结果:最终纳入23篇文献。共得到20个证型,频次最高的证型为风痰内扰证,共提取证素16个,主要病位证素是肝、肾、脾、心,主要病性证素是阳亢、阴虚、动风、外风、痰,关联分析后得到支持度和置信度最高的组合是外风-动风。聚类分析后可得到5个聚类组:(1)痰、动风、外风;(2)肝、阳亢、肾、阴虚;(3)脾、气虚;(4)心、火/热、津亏;(5)胃、血虚、气滞、精亏。共纳入中药98味,其中14味频次≥10,排名前5为白芍、龙骨、钩藤、远志、天麻;分为18类,主要为补虚药、解表药、清热药、安神药、息风止痉药;主归肝、心、肺、脾、肾经;关联规则与聚类分析形成以白芍、熟地黄、天麻、钩藤、石决明、全蝎、珍珠母、龙骨、远志9味药为基础的核心药物组方。结论:儿童TD合并ADHD病位在肝、肾、脾、心,常见病性证素为阴虚、阳亢、动风、外风、痰,以养血滋阴、平肝息风、清热安神为主要治则,核心组方为白芍、熟地黄、天麻、钩藤、石决明、全蝎、珍珠母、龙骨、远志,需根据辨证灵活加减组方。展开更多
Objective:To evaluate the clinical efficacy and safety of Yangxue Qingnao Pills(YXQNP)combined with amlodipine in treating patients with grade 1 hypertension.Methods:This is a multicenter,randomized,double-blind,and p...Objective:To evaluate the clinical efficacy and safety of Yangxue Qingnao Pills(YXQNP)combined with amlodipine in treating patients with grade 1 hypertension.Methods:This is a multicenter,randomized,double-blind,and placebo-controlled study.Adult patients with grade 1 hypertension of blood deficiency and Gan(Liver)-yang hyperactivity syndrome were randomly divided into the treatment or the control groups at a 1:1 ratio.The treatment group received YXQNP and amlodipine besylate,while the control group received YXQNP's placebo and amlodipine besylate.The treatment duration lasted for 180 days.Outcomes assessed included changes in blood pressure,Chinese medicine(CM)syndrome scores,symptoms and target organ functions before and after treatment in both groups.Additionally,adverse events,such as nausea,vomiting,rash,itching,and diarrhea,were recorded in both groups.Results:A total of 662 subjects were enrolled,of whom 608(91.8%)completed the trial(306 in the treatment and 302 in the control groups).After 180 days of treatment,the standard deviations and coefficients of variation of systolic and diastolic blood pressure levels were lower in the treatment group compared with the control group.The improvement rates of dizziness,headache,insomnia,and waist soreness were significantly higher in the treatment group compared with the control group(P<0.05).After 30 days of treatment,the overall therapeutic effects on CM clinical syndromes were significantly increased in the treatment group as compared with the control group(P<0.05).After 180 days of treatment,brachial-ankle pulse wave velocity,ankle brachial index and albumin-to-creatinine ratio were improved in both groups,with no statistically significant differences(P>0.05).No serious treatment-related adverse events occurred during the study period.Conclusions:Combination therapy of YXQNP with amlodipine significantly improved symptoms such as dizziness and headache,reduced blood pressure variability,and showed a trend toward lowering urinary microalbumin in hypertensive patients.These findings suggest that this regimen has good clinical efficacy and safety.(Registration No.ChiCTR1900022470)展开更多
基金Supported by Natural Science Foundation of Shanghai,No.17ZR1431400National Key R and D Program of China,No.2017YFA0103902.
文摘Sotos syndrome is characterized by overgrowth features and is caused by alterations in the nuclear receptor binding SET domain protein 1 gene.Attentiondeficit/hyperactivity disorder(ADHD)is considered a neurodevelopment and psychiatric disorder in childhood.Genetic characteristics and clinical presentation could play an important role in the diagnosis of Sotos syndrome and ADHD.Magnetic resonance imaging(MRI)has been used to assess medical images in Sotos syndrome and ADHD.The images process is considered to display in MRI while wavelet fusion has been used to integrate distinct images for achieving more complete information in single image in this editorial.In the future,genetic mechanisms and artificial intelligence related to medical images could be used in the clinical diagnosis of Sotos syndrome and ADHD.
文摘BACKGROUND Sotos syndrome is an autosomal dominant disorder,whereas attention-deficit/hyperactivity disorder(ADHD)is a neurodevelopmental condition.This report aimed to summarize the clinical and genetic features of a pediatric case of Soros syndrome and ADHD in a child exhibiting precocious puberty.CASE SUMMARY The patient presented with accelerated growth and advanced skeletal maturation;however,she lacked any distinct facial characteristics related to specific genetic disorders.Genetic analyses revealed a paternally inherited heterozygous synonymous mutation[c.4605C>T(p.Arg1535Arg)].Functional analyses suggested that this mutation may disrupt splicing,and bioinformatics analyses predicted that this mutation was likely pathogenic.After an initial diagnosis of Sotos syndrome,the patient was diagnosed with ADHD during the follow-up period at the age of 8 years and 7 months.CONCLUSION The potential for comorbid ADHD in Sotos syndrome patients should be considered to avoid the risk of a missed diagnosis.
文摘Tourette syndrome(TS) is a neurodevelopmental disorder characterized by multiple chronic motor and vocal tics beginning in childhood. Several studies describe the association between TS and attention deficit hyperactivity disorder(ADHD). Fifty percent of children diagnosed with ADHD have comorbid tic disorder. ADHD related symptoms have been reported in 35% to 90% of children with TS. Since ADHD is the most prevalent comorbid condition with TS and those with concomitant TS and ADHD present with considerable psychosocial and behavioral impairments, it is essential for clinicians to be familiar with these diagnoses and their management. This paper highlights the association between treating ADHD with stimulants and the development of tic disorders. The two cases discussed underscore the fact that children with TS may present with ADHD symptomatology prior to the appearance of any TS related symptoms. Appropriate management of TS in a patient diagnosed with ADHD can lead to quality of life improvements and a reduction in psychosocial impairments.
文摘Attention deficit hyperactivity disorder(ADHD) is the most common neurodevelopmental disorder in children and adolescents, with prevalence ranging between 5% and 12% in the developed countries. Tic disorders(TD) are common co-morbidities in paediatric ADHD patients with or without pharmacotherapy treatment. There has been conflicting evidence of the role of psychostimulants in either precipitating or exacerbating TDs in ADHD patients. We carried out a literature review relating to the management of TDs in children and adolescents with ADHD through a comprehensive search of MEDLINE, EMBASE, CINAHL and Cochrane databases. No quantitative synthesis(meta-analysis) was deemed appropriate. Metaanalysis of controlled trials does not support an association between new onset or worsening of tics and normal doses of psychostimulant use. Supratherapeutic doses of dextroamphetamine have been shown to exacerbate TD. Most tics are mild or moderate and respond to psychoeducation and behavioural management. Level A evidence support the use of alpha adrenergic agonists, including Clonidine and Guanfacine, reuptake noradrenenaline inhibitors(Atomoxetine) and stimulants(Methylphenidate and Dexamphetamines) for the treatment of Tics and comorbid ADHD. Priority should be given to the management of co-morbid Tourette's syndrome(TS) or severely disabling tics in children and adolescents with ADHD. Severe TDs may require antipsychotic treatment. Antipsychotics, especially Aripiprazole, are safe and effective treatment for TS or severe Tics, but they only moderately control the co-occurring ADHD symptomatology. Short vignettes of different common clinical scenarios are presented to help clinicians determine the most appropriate treatment to consider in each patient presenting with ADHD and co-morbid TDs.
基金supported by the National Natural Science Foundation of China (81503382), (81603499), (81473521)the National Basic Research Program of China (973 Program) under Grant No.2011CB505106scientific research project of Beijing University of Chinese Medicine (2015-JYB-JSMS036) and (2018-JYB-XJQ009)
文摘Objective: To construct gene co-occurrence network of hypertension and liver-fire hyperactivity syndrome, to investigate the biological basis of hypertension and liver-fire hyperactivity syndrome and the characteristics of the molecular network from gene level.Materials and Methods: Applying Gen CLip 2.0 online platform to retrieve the up-to-date literature referred to essential hypertension from PubMed database, cluster the abnormal expression of essential hypertension-related genes and analyze their function, combining Kyoto encyclopedia of genes and genomes-pathway analysis to investigate the closely related genes and the signaling molecules.Based on the genes closely related to hypertension, standard diagnostic symptoms of liver-fire hyperactivity were used as keywords to conduct hypertension liver-fire hyperactivity-related gene cluster analysis.Results: The top 1000 genes of essential hypertension were retrieved from GenCLip 2.0 online platform, which mainly clustered in the regulation of ambulatory blood pressure, regulation of renin-angiotensin-aldosterone system(RAAS), and sympathetic nervous system activity, as well as endothelial dysfunction; the closely related genes of hypertension with liver-fire hyperactivity are related to RAAS, gene REN, angiotensin converting enzyme, angiotensinogen, and cytochrome P450 family CYP2D6.Conclusion: A combination of literature mining and data mining can construct the gene network of hypertension and the syndrome-related genes, which provides a new method for the study of the biological basis of hypertension from the genetic level.
文摘目的:观察耳尖放血联合天麻钩藤饮治疗肝阳上亢型高血压的临床疗效。方法:选取2022年1月至2024年1月河南中医药大学第一附属医院收治的150例肝阳上亢型高血压患者为研究对象,按照随机数字表法分为对照组和观察组,每组各75例。两组患者均给予硝苯地平控释片,对照组给予天麻钩藤饮,观察组在对照组治疗的基础上联合耳尖放血治疗。比较两组患者临床疗效、不良反应发生情况及治疗前后中医证候积分、血压情况、生活质量评分、肾功能指标[尿微量白蛋白(microalbuminuria,MAU)、尿肌酐清除率、尿微量白蛋白与肌酐比值(albumin creatinine ratio,ACR)]。结果:治疗后,观察组中医证候积分分别为:头晕目眩(1.15±0.13)分、面红目赤(1.31±0.16)分、急躁易怒(1.50±0.20)分、口苦口干(1.39±0.27)分,总分(5.31±0.64)分,均低于本组治疗前及对照组治疗后,差异具有统计学意义(P<0.05)。观察组有效率为98.67%,高于对照组的76.00%,差异具有统计学意义(P<0.05)。治疗后,观察组患者收缩压(136.58±11.26) mm Hg,舒张压(85.91±5.40) mm Hg,24 h收缩压(136.67±9.46) mm Hg,24 h舒张压(81.62±5.13) mm Hg,下降幅度均显著高于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组生活质量评分分别为:生理机能(75.79±5.82)分、生理职能(73.18±0.55)分、躯体疼痛(72.42±6.43)分、一般健康状况(59.57±4.59)分、精力(64.58±5.57)分、社会功能(66.48±5.65)分、情感职能(75.85±4.38)分、精神健康(66.82±5.29)分,高于本组治疗前及对照组治疗后,差异具有统计学意义(P<0.05)。治疗后,观察组MAU为(20.56±4.43)μg·g^(-1),尿肌酐清除率为(1.89±0.46) g·24 h^(-1)、ACR为(10.29±2.69),低于本组治疗前及对照组治疗后,差异具有统计学意义(P<0.05)。观察组不良反应发生率为5.33%,低于对照组的18.67%,差异具有统计学意义(P<0.05)。结论:耳尖放血联合天麻钩藤饮治疗肝阳上亢型高血压,临床疗效确切,能够显著降低中医证候积分,稳定血压,改善肾功能及生活质量,且不良反应发生率较低。
文摘目的:基于R语言初步探讨儿童抽动障碍(TD)合并注意缺陷多动障碍(ADHD)的证型证素及中医用药规律。方法:计算机检索CNKI、万方、维普、CBM、PubMed、the Cochrane Library、EMBase、Web of Science等数据中建库至2023年11月10日收录的所有中医药治疗TD合并ADHD的文献,采用Excel软件筛选文献,对证型证素及中药规范化整理后,建立数据库,运用R语言及RStudio软件进行相应的数据挖掘,包括关联分析和聚类分析,探索儿童TD合并ADHD证型证素分布及中药分布规律。结果:最终纳入23篇文献。共得到20个证型,频次最高的证型为风痰内扰证,共提取证素16个,主要病位证素是肝、肾、脾、心,主要病性证素是阳亢、阴虚、动风、外风、痰,关联分析后得到支持度和置信度最高的组合是外风-动风。聚类分析后可得到5个聚类组:(1)痰、动风、外风;(2)肝、阳亢、肾、阴虚;(3)脾、气虚;(4)心、火/热、津亏;(5)胃、血虚、气滞、精亏。共纳入中药98味,其中14味频次≥10,排名前5为白芍、龙骨、钩藤、远志、天麻;分为18类,主要为补虚药、解表药、清热药、安神药、息风止痉药;主归肝、心、肺、脾、肾经;关联规则与聚类分析形成以白芍、熟地黄、天麻、钩藤、石决明、全蝎、珍珠母、龙骨、远志9味药为基础的核心药物组方。结论:儿童TD合并ADHD病位在肝、肾、脾、心,常见病性证素为阴虚、阳亢、动风、外风、痰,以养血滋阴、平肝息风、清热安神为主要治则,核心组方为白芍、熟地黄、天麻、钩藤、石决明、全蝎、珍珠母、龙骨、远志,需根据辨证灵活加减组方。
基金Supported by the Geriatric Medicine Development Fund of the China Health Promotion Foundation(No.2020-SRXY-045)。
文摘Objective:To evaluate the clinical efficacy and safety of Yangxue Qingnao Pills(YXQNP)combined with amlodipine in treating patients with grade 1 hypertension.Methods:This is a multicenter,randomized,double-blind,and placebo-controlled study.Adult patients with grade 1 hypertension of blood deficiency and Gan(Liver)-yang hyperactivity syndrome were randomly divided into the treatment or the control groups at a 1:1 ratio.The treatment group received YXQNP and amlodipine besylate,while the control group received YXQNP's placebo and amlodipine besylate.The treatment duration lasted for 180 days.Outcomes assessed included changes in blood pressure,Chinese medicine(CM)syndrome scores,symptoms and target organ functions before and after treatment in both groups.Additionally,adverse events,such as nausea,vomiting,rash,itching,and diarrhea,were recorded in both groups.Results:A total of 662 subjects were enrolled,of whom 608(91.8%)completed the trial(306 in the treatment and 302 in the control groups).After 180 days of treatment,the standard deviations and coefficients of variation of systolic and diastolic blood pressure levels were lower in the treatment group compared with the control group.The improvement rates of dizziness,headache,insomnia,and waist soreness were significantly higher in the treatment group compared with the control group(P<0.05).After 30 days of treatment,the overall therapeutic effects on CM clinical syndromes were significantly increased in the treatment group as compared with the control group(P<0.05).After 180 days of treatment,brachial-ankle pulse wave velocity,ankle brachial index and albumin-to-creatinine ratio were improved in both groups,with no statistically significant differences(P>0.05).No serious treatment-related adverse events occurred during the study period.Conclusions:Combination therapy of YXQNP with amlodipine significantly improved symptoms such as dizziness and headache,reduced blood pressure variability,and showed a trend toward lowering urinary microalbumin in hypertensive patients.These findings suggest that this regimen has good clinical efficacy and safety.(Registration No.ChiCTR1900022470)