The Study Of Relationships Of The Mixed Stasis-Heat Symptom In The Hypertension With Insulin Resistance And Inflammatory Cytokines

Although the denomination of hypertension can not be found in traditional Chinesemedicine (TCM), hypertension remains with illness of giddiness and headache and strokein TCM because of its symptoms. Lots of chinese medicals have different viewpoints abouthypertension pathogenesis in TCM, such as wind, heat, sputum, stasis and difficiency.Under the influence of constitutional make up factor, emotional factor, modem lifestyle,many Chinese medicals emphasis the important effect of stasis and heat in hypertension. Atcertain stages of the development of acute exonenous febrile diseases and some internaldiseases, heat and stasis may be present at the same time in many patients,which becomecommon pathology in these diseases. In the present study, we have explored therelationships of the mixed stasis-heat symptom with hypertension in the theoretic research.We have discussed the clinical characters and the pathological basic of the mixedstasis-heat symptom in hypertension.Based on the theories about apoplexy in TCM, it is put forward in this paper that theblood stasis and heat accumulated is the key pathogenesis for hypertention. At certainstages of the development of hypertension, heat can cause the formation of blood stasis, atthe same time, the stasis can cause the formation of heat, which combine to form a specialsyndrome damageing to the zang-fu organs. The main treatment is to begiven with coolingheat and clearing stasis therapy, including many functions like clearing away heat, coolingthe blood and stopping bleeding, promoting blood circulation to remove blood stasis,purging heat.In morden medicine, many pathogenesis and pathological factors can causehypertension, theoretic and clinical research verify the result that insulin resistance(IR)cause hypertension and damage to the target organ, complication appearance played an importantrole. More and more specialists emphasise the relation between the hypertension and the inflammation.Increased levels of C-reactive protein(CRP), tumour necrosis Factor-α(TNF-α), interleukin-6(IL-6), etc, the markers of inflammation are associated with incident hypertension, and they think it isan inflammation disease.Today, many chinese medicals found the importance of the stasis and heat in the process of the hypertension. The main treatment that cooling heat and clearing stasis haveincrease the insulin sensitive. It is possible that IR and inflammation are relate to the mixedstasis-heat symptom.Objective Investigate the clinical characters and the pathological basic of the mixedstasis-heat symptom in hypertension to clarify the importance of the mixed stasis-heat.Provide scientific evidence to differentiate and treat the mixed stasis-heat symptom inhypertension.(1) To observe the age, course of hypertension, body mass index(BMI), serum lipids,risk degree, target organ injury, clinical supervention in order to investigate the clinicalcharacters of the mixed stasis-heat symptom in hypertension.(2) Measurement indicators included the insulin sensitivity index (ISI), TNF-α, IL-6,CRP in order to investigate the relationships of the insulin resistance(IR) with theinflammatory cytokines.(3) To observe the relationships of the IR and the inflammatory cytokines with themixed stasis-heat symptom in hypertension in order to investigate the pathological basic ofthe mixed stasis-heat symptom.Methods The hypertension patients were divided to two groups, the mixedstasis-heat symptom group and without stasis-heat symptom group, which compare with thenormal controlled group. Measurement indicators included stature, weight, serum lipids,total cholesterol(TC), high density lipoprotein-cholesterol (HDL-C), low densitylipoprotein -cholesterol (LDL-C), triacylglycerol (TG), fasting plasma glucose (FPG),fasting serum insulin (FINS), TNF-α, IL-6, CRP, BMI and ISI were calculated.Results(1)There were significant statistical differce on the age, course of hypertension, BMI,serum lipids, such as TC, TG, LDL-C, risk degree, target organ injury, clinical superventionbetween the mixed stasis-heat symptom group and without stasis-heat symptom group inhypertension.(2)The level of FINS, TNF-αand IL-6 increased in hypertension group, as comparedwith normal group. The level of ISI de creased in hypertension group, as compared withnormal group. But there was no significant statistical differce on the level of CRP in twogroups, there were negative relationships between IR and the plasma level of IL-6, TNF-α,BMI, TC, TG, LDL-C in hypertensive patient.(3) There were significant statistical differce on the level of ISI, IL-6, TNF-αbetween the mixed stasis-heat symptom group and without stasis-heat symptom group inhypertension.Conclusion The mixed stasis-heart symptom is correlated with the age, course ofhypertension, BMI, serum lipids, such as TC, TG, LDL-C, risk degree, target organ injury,clinical supervention. The hypertensive patients show a higher insulin resistance.Subclinical inflammation probably exists in hypertension patients. The IL-6, TNF-α, BMI,TC, TG, and LDL-C are independent risk factors of insulin resistance. IR and Subclinicalinflammation are the part of the patholonical basis for the mixed stasis-heart symptom.