Abstract: AIM: To observe the effects of naoxinduotai capsule (active principles of tribulus terrestris) on carotid artery remodeling in a randomized controlled clinical trial. METHODS: A randomized controlled trial was designed. Forty patients of asthenic yin causing predominant yang with primary hypertension (PH) were divided into two groups (n=20 each): naoxinduotai capsule plus perindopril (trial group) and Perindopril group (control group). The patients' total of penthemeron integration syndrome, blood pressure, blood glucose, blood lipids and liver and kidney function were examined before and after treatment. Echo tracking ultrasonic parameters of carotid including pressure-strain elastic modulus (Ep), stiffness parameter (β), arterial compliance (AC), pulse wave velocity (PWV), augmentation index (AI), maximum vessel diameter, minimum vessel diameter, and intima media thickness (IMT) were obtained with echo tracking ultrasound technique. RESULTS: The sum of penthemeron integration syndrome had a statistically significant decreasing tendency after treatment, but the total in the trial group was statistically significantly lower than in the control group. EP, β and PWV decreased in a statistically significant manner and AC was statistically significantly increased in the trial group, whereas only statistically significantly decreased EP and PWV decreased in a statistically significant manner in the control group (P<0.05). CONCLUSION: Naoxinduotai capsule combined with perindopril shows better results in not only improving clinical symptoms of asthenic yin causing predominant yang symptom with PH, but also shows better results in inhibiting arotid artery stiffness and compliance degradation compared with perindopril alone.