The Study On Cluster Analysis Of TCM Syndromes On OSAHS With Hypertension And Its Correlation With Plasma Homocysteine

ObjectiveTo establish the TCM syndrome differentiation of obstructive sleepapnea hypopnea syn drome with hypertension by cluster analysis.To explore the correlation between OSAH S syndrome and plasma homocysteine.Methods1.Collected from people’s hospital affiliated to fujian university of traditional Chinese medicine lung disease,cardiovascular division and fujian medical university first affiliat ed hospital sleep center of diagnosis and treatment of respiratory diseases in March 2018 a January 2019 OSAHS of outpatient and hospitalization of hypertension patients i n 118 cases,and records of the patient’s general condition in the form of questionnair e survey,symptoms,signs,coating on the tongue and pulse condition information,and the next day early in the morning on an empty stomach take related parameters of plas ma homocysteine serum samples.2.Statistical software SPSS20.0 was used for statistical analysis of all the data.After O SAHS syndrome types combined with hypertension were statistically analyzed,the corre lation between each syndrome type and HCY and related PSG was analyzed.Results1.Among 118 OSAHS patients with hypertension collected in this study,74（62.7%）we re male and 44（37.3%）were female.The youngest was 23 years old,the oldest was 80 years old,and the average age was 56.22±13.34 years old.BMI≥24kg/m² accounted fo r 82.20%,among which BMI>28.00kg/m² accounted for 60.17%.2.Through cluster analysis on the symptoms,signs,tongue LIDS,pulse and other variab les of 118 patients with OSAHS complicated with hypertension,the syndrome differenti ation was finally divided into four syndromes:phlegm-heat internal disturbance syndrom e,phlegm-blood stasis syndrome,spleen deficiency and dampness syndrome,and qi defici ency and blood stasis syndrome.Its distribution was phlegm-heat internal disturbance sy ndrome（29.7%）>phlegm-heat internal disturbance syndrome（27.1%）>syndrome of qi de ficiency and blood stasis syndrome（22.9%）>syndrome of spleen deficiency and dampn ess syndrome（20.3%）.According to disease,empirical evidence and false and real mixe d evidence can be classified into two categories,among which 67 cases are empirical e vidence（56.8%）and 51 cases are false and real mixed evidence（43.2%）.3.BMI and ESS scores of each group were pairwise compared.The results showed that BMI of spleen deficiency and dampness syndrome was higher than that of phlegm-he at internal disturbance syndrome and phlegm-stasis interaction syndrome（P<0.01）.The r emaining pairwise comparison showed no significant difference（P>0.05）.ESS score of s pleen deficiency syndrome is highest in 4 types（P<0.01）.4.In terms of AHI,the mixed syndromes of deficiency and solid（spleen deficiency and dampness syndrome,qi deficiency and blood stasis syndrome）are higher than the pure positive syndromes（phlegm and blood stasis syndrome,internal disturbance of phleg m heat）（P<0.01）,and qi deficiency and blood stasis syndrome>spleen deficiency and d ampness syndrome>phlegm-stasis interaction syndrome>phlegm-heat internal disturbance syndrome（P<0.01）.Factors（pixu（spleen deficient）wet trapped certificate qi deficienc y and blood stasis）LSaO2 lower than pure empirical（mutual phlegm and blood stasis syndrome,phlegm heat inside one）（P<0.01）.There was no significant difference betwe en pure false and true inclusion syndrome（P>0.05）,and no statistical significance betw een pure positive evidence（P>0.05）.5.Plasma HCY was decreased successively in the syndromes of deficiency and solid（qi deficiency and blood stasis,spleen deficiency and dampness）and pure positive syn dromes（phlegm and blood stasis interjunction,phlegm and heat internal disturbance sy ndrome）.The HCY level of the steady-state model evaluation in phlegm-heat internal d isturbance syndrome,hlegm-blood stasis syndrome,spleen deficiency dampness-sheng s yndrome and Yin and Yang deficiency syndrome increased successively（P<0.01）.6.The overall distribution of OSAHS severity is mainly moderate,followed by severe a nd mild.The syndrome of qi deficiency and blood stasis and spleen deficiency and d ampness were the most severe and the least mild.Phlegm and blood stasis syndrome and phlegm heat internal disturbance syndrome were more moderate,mild and less seve re.7.OSAHS severity was positively correlated with plasma HCY level.AHI and plasma HCY were positively correlated.There was a negative correlation between LSaO₂ and p lasma HCY（all P<0.01）.Conclusion1.The incidence of OSAHS combined with hypertension is higher in men than in wo men,and the incidence of obesity and middle-aged and elderly people is higher.2.The results of cluster analysis were divided into four syndromes:phlegm-heat internal disturbance syndrome,phlegm-blood stasis syndrome,spleen deficiency dampness syndro me,qi deficiency and blood stasis syndrome.3.Plasma HCY was increased successively in phlegm-heat internal disturbance syndrom e,phlegm-blood stasis syndrome,spleen deficiency dampness syndrome,and qi deficiency and blood stasis syndrome.4.OSAHS severity was positively correlated with plasma HCY.AHI and plasma HCY were positively correlated.There was a negative correlation between LSaO₂ and plasma HCY.