| Purpose:The first part:using retrospective study to explore the distribution of symptoms and syndrome differentiation of six channels theory of primary hypertension with carotid atherosclerosis,and to study the correlation between gender,age,common complications and six meridians disease,so as to provide reference for clinical syndrome differentiation and treatment of traditional Chinese medicine.The second part:The patients with Shaoyin heat syndrome in essential hypertension complicated with carotid atherosclerosis were randomly divided into two groups.On the premise of using 20mg atorvastatin as the basic treatment,the experimental group was intervened by Ziyin Qingre method(Songling Xuemaikang Capsule+Qianyang Yuyin granule),while the control group was blank control without additional intervention.By comparing the TCM syndrome score,blood lipid level difference,IMT and Crouse score between the two groups before and after treatment,the following problems were clarified:① to evaluate whether the method of nourishing yin and clearing heat has advantages over conventional treatment;② to explore the clinical value of the method of nourishing yin and clearing heat in the treatment of primary hypertension complicated with carotid atherosclerosis.method:The first part:adopt the method of cross-sectional study,collect the medical record data of the patients with primary hypertension and carotid atherosclerosis admitted to Jiangsu traditional Chinese medicine hospital from March 2017 to March 2019,collect the basic data(including gender,age)and clinical data(complaints,medical history,four diagnosis information,physical examination,complications information).Based on the theory of syndrome differentiation of six meridians,this paper makes a new syndrome differentiation and analysis.The selected patients need to meet the diagnostic criteria of hypertension and carotid atherosclerosis.Through statistical analysis,the relationship between gender,age,common complications and six meridians disease was studied.The second part:A total of 60 patients with essential hypertension and carotid atherosclerosis were collected and randomly divided into two groups,30 cases in the experimental group and 30 cases in the control group.The experimental group was given Songling-Xuemaikang Capsule plus Qianyang-Yuyin granules,while the control group was not given additional drug intervention.By observing the TCM syndrome score,blood lipid level difference,carotid intima-media thickness difference,Crouse score difference before and after treatment,to evaluate the effect of the method of nourishing yin and clearing heat in the treatment of primary hypertension complicated with carotid atherosclerosis.result:PartⅠ:1.According to statistics,164 cases(39.2%)of the 418 cases of hypertension complicated with carotid arteriosclerosis were heat transformation of Shaoyin disease,143 cases(34.2%)were shaoyang disease,and 6 cases(1.4%)were Taiyin disease2.Among the 418 patients,the most common single channel disease was 287(68.7%),followed by the second economic cooperation disease(29.9%),in which the highest frequency was Shaoyang Shaoyin heat combined disease in 35 cases,followed by Shaoyang Shaoyin cold combined disease in 22 cases.There were only 6 cases(1.4%)of three meridians combined disease3.Through the analysis of six meridians disease and age,sex,comorbidity(including hyperlipidemia,angina/coronary heart disease,lacunar cerebral infarction,type 2 diabetes,cholecystitis/gallstone,fatty liver):① with the increase of age,the incidence of Yangming disease increases;② the probability of Yangming disease in female patients is higher than that in male patients;③ the incidence of Jueyin disease in patients with cholecystitis/gallstone Increase.4.418 patients’ symptoms included palpitation(106 cases,accounting for 25.3%),insomnia and dreaminess(95 cases,accounting for 22.7%),lethargy(92 cases,accounting for 22.0%),chest distress(82 cases,accounting for 19.6%),dizziness(73 cases,accounting for 17.5%),fatigue(58 cases,accounting for 13.9%),chest pain(44 cases,accounting for 10.5%).The second part:1.After treatment,the TCM syndrome scores of the two groups were significantly reduced,in which the average value of the experimental group was lower than that of the control group,and the difference between the two groups was significant after treatment.2.The IMT of carotid artery in the treatment group and the control group increased after treatment,but there was no significant difference between the experimental group and the control group after treatment.The difference of IMT before and after treatment in the treatment group was less than that in the control group,that is,the method of nourishing yin and clearing heat method has advantages over conventional lipid-lowering therapy in delaying the thickening of carotid intima-media.3.The mean size of carotid plaque in the treatment group decreased slightly before and after treatment,while that in the control group increased.After treatment,the mean size of carotid plaque in the treatment group was smaller than that in the control group,that is,in the conventional treatment,the carotid plaque continued to increase,while the treatment of the method of nourishing yin and clearing heat could reduce the carotid atherosclerotic plaque.4.After treatment,the average crouse score of treatment group and control group decreased slightly.After treatment,there was no significant difference between the two groups,that is,there was no significant difference in the improvement effect of crouse score between the two groups.5.There was no significant difference in blood lipid level between the two groups before and after treatment,and there was no significant difference between the two groups after treatment,that is,the effect of nourishing yin and clearing heat method on blood lipid level was not obvious,and there was no obvious advantage compared with conventional treatment.6.During the treatment,there were no adverse reactions in both groups.ConclusionPart Ⅰ:1.The frequency of the six meridians syndrome of hypertension with carotid atherosclerosis is:Shaoyin heat syndrome,shaoyang disease,Shaoyin cold syndrome,Jueyin disease,Taiyang disease,Yangming disease and Taiyin disease.Hypertension with carotid atherosclerosis is mainly single channel disease,followed by two OECD disease,three channel disease is rare,no more than three channel disease.2.The frequency of ECD from high to low is Shaoyang Shaoyin heat,Shaoyang Shaoyin cold,Shaoyin heat Jueyin,sun Shaoyang,Shaoyin cold Jueyin,Shaoyang Jueyin,sun Shaoyin cold,Yangming Shaoyin heat,Shaoyang Yangming,Taiyin Shaoyin cold,sun Shaoyin heat,Yangming Shaoyin cold,sun Taiyin Jueyin.3 Yangming disease may increase with age and the incidence rate of Yangming disease in female patients is higher than that in men.4.Cholecystitis/cholelithiasis is a risk factor of Jueyin disease in patients with hypertension and carotid atherosclerosis:5.Syndrome differentiation of six channels theory is a feasible method for the diagnosis and treatment of hypertension with carotid atherosclerosis.Part Ⅱ:1.The method of nourishing yin and clearing heat can better improve the TCM syndrome of patients with essential hypertension complicated with carotid atherosclerosis,reduce the discomfort symptoms of patients,and improve the quality of life.2.The method of nourishing yin and clearing heat has certain advantages in slowing down the thickening of carotid intima-media,and the method of nourishing yin and clearing heat can prevent the growth of carotid plaque size and even reduce the plaque size.3.The method of nourishing yin and clearing heat had no obvious effect on blood lipid level.4.The method of nourishing yin and clearing heat is safe and reliable in the treatment of primary hypertension complicated with carotid atherosclerosis,which is a feasible clinical treatment. |
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