To observe syndrome differentiation and treatment combined with Zixie modified decoction on individual symptoms of hypertension, in order to identify indications of the combined treatment. Methods: Patients with primary hypertension (n=140) were randomized to two groups, one group was given treatment based on syndrome differentiation, the other group was given modified Zixie decoction in addition. We observed overall symptom scores and individual symptom scores in patients of the same type on day 0 and day 28. Results: Comparison of total scores of a same type between groups: Overabundant liver fire was no significantly different (P>005), vacuity pattern, phlegm dampness card, yin and yang deficiency were significantly different (P<001),and observation group was superior to control group. Comparison of individual symptom scores: both groups relieved individual symptoms for type of Overabundant liver fire; observation group was not statistically better in other 3 types (P> 005). Conclusion: Compared with syndrome differentiation treatment alone, the combined treatment showed advantage for treatment of vacuity pattern, phlegm dampness, Yin and Yang deficiency, in terms of relief of overall symptoms. Regarding Overabundant liver fire, the difference is not significantly better.