Objective To explore the effect of Bushen Yixin Tablets （补肾益心片） on early hypertensive nephrosclerosis（EHN） in primary hypertension patients with kidney yang deficiency as well as the possible mechanism of action. Methods Sixty enrolled patients were randomly divided into treatment group and control group with 30 cases in each group. The control group was given Western medicine for antihypertensive treatment

while the treatment group was orally administered with Bushen Yixin Tablets in addition

1.25 g per time

three times a day; the treatment course was one month in both groups. The systolic blood pressure

diastolic blood pressure

and traditional Chinese medicine（TCM） syndrome score before and after treatment were assessed and compared between groups

and the levels of urine microalbumin（mALB）

urine β2 microglobulin（β2-MG）

estimated glomerular filtration rate（eGFR） and pro-fibrotic factors such as angiotensin Ⅱ（AngⅡ）

transforming growth factor β1（TGF-β1） and connective tissue growth factor（CTGF） were also assessed and compared. The effect in decreasing blood pressure and improving TCM syndromes were evaluated. Results In terms of the antihypertensive effect

the total effective rate of treatment group was 96.67%

which was higher than 90.00% of the control group（P<0.05）; regarding the improvement of TCM syndromes

the total effective rate of the treatment group was 86.67%

significantly higher than 73.33% of the control group（P<0.05）). After treatment

the diastolic blood pressure of the treatment group was significantly lower than that of the control group（P<0.05）

while there was no statistically difference in systolic blood pressure between groups（P>0.05）. The results favored treatment group than control group in improving clinical symptoms including chills

weakness of knees

insomnia and profuse dreaming

as well as tongue and pulse conditions（P<0.05）. The total TCM syndrome score significantly decreased after treatment in both groups（P<0.05）

and more decrease was seen in treatment group than in control group（P<0.05）. The treatment group was better than the control group in reducing the levels of urine mALB and β2-MG

serum AngⅡ

TGF-β1

and CTGF（P<0.05）. Conclusion Bushen Yixin Tablets can significantly lower the blood pressure

improve the clinical symptoms and reduce the EHN-related sensitive indicators in EHN patients with kidney yang deficiency

and the inhibition of AngⅡ

TGF-β1

CTGF and other profibrotic factors may be related to the mechanism of action.