Abstract： Objective： To observe the clinical effect of the therapy of Tianma Gouteng Granules combined with Irbesartan on the treatment of hypertension. Methods： A total of 80 patients with hypertension were randomly divided into the observation group and the control group，with 40 patients in each group. The control group was given Irbesartan Tablets orally， and the observation group was additionally given Tianma Gouteng Granules based on the treatment of the control group. The clinical effects in the two groups were evaluated，and the blood pressure，levels of vasoactive substances and symptom scores in the two groups were compared before and after treatment. Results：The total effective rate was 95.00% in the observation group， higher than that of 77.50% in the control group (P＜0.05). After treatment，the 24-hour average systolic blood pressure (SBP) and 24-hour average diastolic blood pressure (DBP) in the two groups were decreased when compared with those before treatment (P＜0.05)； the 24- hour average SBP and 24- hour average DBP in the observation group were lower than those in the control group (P＜0.05). After treatment，the levels of nitric oxide (NO) were increased，and the levels of endothelin (ET) and angiotensin II (AngII) were decreased in the two groups when compared with those before treatment (P＜0.05)； the level of NO in the observation group was higher than that in the control group， and the levels of ET and AngII were lower than those in the control group (P＜0.05). After treatment， the symptom scores in the two groups were decreased when compared with those before treatment (P＜0.05)， and the symptom scores in the observation group were lower than those in the control group (P＜0.05). Conclusion： The therapy of Tianma Gouteng Granules combined with Irbesartan has a good therapeutic effect on the treatment of hypertension patients，which can reduce blood pressure variability，restore the levels of vasoactive substances and improve clinical symptoms.