Mechanism of Action and Clinical Research Progress of Gastrodia and Uncaria Decoction in Treating Hypertension

Abstract

Hypertension, a major global public health issue, affects 27.9% of adults in China, with approximately 245 million patients. However, treatment and control rates stand at only 45.8% and 16.8%, respectively, indicating a significant “diagnosis and treatment gap.” While modern Western drugs form the cornerstone of antihypertensive therapy, their single-target mechanisms often induce residual symptoms like dizziness and headaches, along with long-term side effects, and provide insufficient protection for target organs. Against this backdrop, the unique advantages of Traditional Chinese Medicine (TCM)—its holistic regulation and multi-target interventions — become increasingly prominent. As a classical formula, Tianma Gou Teng Yin centers on calming liver yang and extinguishing wind, while also clearing heat, promoting blood circulation, and tonifying the liver and kidneys—aligning with the “excessive liver yang” pathogenesis of hypertension. This study systematically reviews the hypotensive mechanisms and clinical application progress of Tianma Gou Teng Yin through literature retrieval and analytical synthesis. Tianma Gou Teng Decoction regulates blood pressure through multiple synergistic pathways: First, it inhibits excessive activation of the renin-angiotensin-aldosterone system (RAAS), reducing levels of angiotensin II (Ang II) and aldosterone (ALD); Second, it modulates vascular endothelial function by upregulating nitric oxide (NO) and suppressing endothelin-1 (ET-1). Third, it inhibits inflammation mediated by the nuclear factor kappa-B (NF-κB) pathway while enhancing antioxidant enzyme activity, such as superoxide dismutase (SOD). Network pharmacology further reveals its “multi-component-multi-target-multi-pathway” characteristics. Components such as gastrodin and uncarin act on targets like AKT1 and CASP3 to regulate MAPK and PI3K-Akt signaling pathways. Combining Gastrodia and Uncaria Decoction with Western medications significantly enhances antihypertensive efficacy and alleviates symptoms like dizziness and insomnia without increasing adverse reaction risks. Its protective effects on target organs such as the heart and kidneys have also been validated: it delays left ventricular hypertrophy by inhibiting the renin-angiotensin-aldosterone system (RAAS) and reduces renal injury by lowering urinary microalbuminuria. However, current research still faces challenges including insufficient mechanistic depth, room for improvement in clinical evidence quality, and a lack of standardized formulations. Future efforts should include multicenter randomized controlled trials to optimize efficacy evaluation, integrate metabolomics and gut microbiota research to deepen mechanism analysis, and establish quality control standards for herbal materials. This study provides scientific basis for the clinical translation of Gastrodia and Uncaria Decoction and expands new perspectives for its application in complex disease management.