Effect of Sacubactril Valsartan Combined with Astragalus Angelica Mixture on Renal Function and Serum HMGB1 and IL-6 Levels in Patients with Primary Hypertension and Early Renal Injury

LI Yong; SU Yakun; ZHANG Hongbo; YAN Xiaoju; LI Zhanhu

doi:10.12102/j.issn.1672-1349.2025.04.019

Abstract：Objective: To explore the effect of sacubitril/valsartan combined with Huangqi Dangui mixture on renal function and serum high mobility group box 1 (HMGB1) and interleukin-6 (IL-6) levels in patients with early renal injury due to primary hypertension. Methods: A total of 130 patients with early renal injury due to primary hypertension were enrolled and randomly divided into an observation group (67 cases) and a control group (63 cases). The control group received sacubitril/valsartan treatment, while the observation group received additional treatment with Huangqi Dangui mixture on top of the control group's treatment for a continuous period of 3 months. The changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and TCM syndrome scores before and after treatment were observed in both groups. The levels of renal function indicators, including serum creatinine (sCr), urinary albumin-to-creatinine ratio (UACR), and serum cystatin C (CysC), as well as inflammatory factors such as serum HMGB1 and IL-6, were compared before and after treatment. The occurrence of adverse drug reactions during treatment was also observed. Results: After treatment, SBP and DBP in both groups significantly decreased compared to pre-treatment levels (P < 0.01), with no statistically significant difference between the two groups (P > 0.05). Both groups showed a significant decrease in TCM syndrome scores after treatment, with the observation group showing a more pronounced reduction (P < 0.05). After treatment, sCr, UACR, and CysC levels in both groups significantly decreased compared to pre-treatment levels, and the observation group had significantly lower levels of sCr, UACR, and CysC than the control group (P < 0.05). After treatment, HMGB1 and IL-6 levels in both groups significantly decreased compared to pre-treatment levels. Compared with the control group, the observation group showed a more significant reduction in HMGB1 and IL-6 levels after treatment (P < 0.05). There was no statistically significant difference in the incidence of adverse drug reactions between the two groups (P > 0.05). Conclusion: Sacubitril/valsartan combined with the traditional Chinese medicine preparation Huangqi Dangui mixture can improve renal function in patients with early renal damage caused by hypertension, with good safety and certain regulatory effects on inflammatory factor levels.