| Objectives1.From the perspective of literature,to understand the main characteristics of yin deficiency and yang deficiency in TCM Constitution2.The correlation between hypertension and the clinical data of asthenia syndrome was analyzed.3.The relationship between yin deficiency and yang deficiency and hypertension was explored through the study of the physique and symptom characteristics of the elderly hypertension population from medical& nursing facility mainly in Changsha city.4.In order to establish a simple two-dimensional identification table of yin asthenia and yang deficiency in the elderly patients with chronic diseases,and to provide a simple assessment tool for the elderly and primary medical workers in thecommunity.5.Taking the main risk factors as the intervention point,the content module and health education mode of TCM health education were constructed.Methods1.Based on the hypothesis that different body types have different characteristics,through the literature study,we collect and collate the literature to understand the main characteristics of yin deficiency and yang deficiency.2.Based on a certain association between the Constitution and certain diseases(the association between the physique and prevalent diseases),a retrospective study of the cases was used to analyze the clinical features of the elderly HTN patients with deficiency syndrome,and to explore the relationship between the clinical manifestations of hypertension and the performance of deficiency deficiency.3.On the basis of preliminary research,a method of convenient sampling applied to this study according to Dr.Wang Qi’s "classification and determination scale of TCM Constitution and the aged(65 years old)".In order to understand the constitute and symptomatic characteristics of the elderly hypertensive withyin deficiency and yang deficiency,we selected elderly hypertensive patients that’s recognized as yin or yang deficiency constitution from 5 large top-three hospitals in Changsha and 8nursing homes both in Changsha and Xiangtan,collected relevant data and analyzed them with Chi-Square Test,frequency statistics and other methods.4.Based on the study of the main symptoms & symptoms elements of primary hypertension with Yin deficiency or yang deficiency syndrome,the simple identification table of yin deficiency and yang deficiency of senile chronic diseases(hypertension)in elderly patients(hypertension,yin deficiency /yang deficiency physique and syndrome element)was established by quantitative method and expert demonstration,and then was verified.5.In the previous study,the factors of hypertension / Yin deficiency and yang deficiency were considered as risk factors.Combining the characteristics of the physiological function and cognitive function of the elderly people,the "20-80" rule was adopted to construct the "3-halls and 2-layers" content module to highlight the health education intervention of TCM,and to explore the key elements qualified to put on the top of the healtheducation.The health education mode provides empirical evidence for the community to achieve targeted health education for elderly hypertension.Results1.There are different definitions of yin deficiency and yang deficiency in modern Chinese medicine,but the main syndrome elements are similar.Qi deficiency,yin deficiency and yang deficiency are the most common types of constitution in the elderly with hypertension.The high-frequency syndrome elements of yin deficiency is mainly the dry mouth or pharynx,tachycardia and chord pulse,hot flushing in hands or feet,emaciation,reddened tongue with dryness and less coating,less sleep and night sweats and so on;The high-frequency syndrome elements of Yang deficiency cold fits,cold limbs,preferring hot food,the tongue is pale red,fat,tender,toothed and moisten,the pulse is slightly sunk,late and weak,the face is soft and white,also stool is loose,urine is clear.2.The top-5 clinical symptoms of hypertension patients were dizziness,dry mouth,sleep disorders,body pain and fatigue.Symptoms of asthenia syndrome were dizziness,dry mouth,sleep disorders,headache,fatigue,bitter taste,chills,and abnormalstool.The deficiency syndrome of hypertension is characterized by dizziness,dry mouth and sleep disorders.3.Hypertension is biased in constitution from low to high in order of qi deficiency,yin deficiency,Yang deficiency and phlegm dampness.Compared with other physique,the frequency of qi deficiency was significantly higher than other physical frequencies,and the difference was statistically significant(P <0.05).The frequency of yin deficiency constitution was significantly different from that of other constitution except Yang deficiency(P < 0.05).There were significant differences in the level of temperament and phlegm dampness in the elderly patients with hypertension(P < 0.05).Compared with women,men have a higher proportion of temperament and phlegm dampness.The type of physique,sex and age can affect the clinical characteristics of the elderly chronic diseases(hypertension).The most common manifestation of Yang deficiency,blood stasis and qi stagnation of chronic diseases(hypertension)was the dizziness,and there were differences in dizziness,headache and head weight in male and female,and the difference was statistically significant(P <0.05).The elderly chronic diseases(hypertension)in different age groups have statistical significance(P < 0.05),and there is nodifference in the occurrence of hypertension(P < 0.05)in patients with different age.4.The frequency of hypertension symptoms was the highest for dizziness(216)and fatigue(214).The order of descending order was chest tightness(195),panic(191),and hearing loss(177).Among the patients with chronic diseases of yin deficiency,the most frequent symptoms of hypertension were fatigue(66.06%),and the most frequent symptoms of hypertension were dizziness(71.10%),and the most common Yin deficiency related syndromes were lip dry(80.73%),followed by lingual red(74.31%),and oral pharynx.Dryness(71.56%),the most common Yang deficiency syndrome is usually afraid of cold(84.40%),the only following is like warm diet(74.40%),character calm,quiet(70%).In this study,the frequency of amnesia was the highest in the elderly patients with hypertension,and the frequency of asthenia was the highest in patients with Yin deficiency,phlegm dampness and Qi deficiency,and the highest frequency of dizziness appeared in those with Yang deficiency and blood stasis.5.According to the data analysis to 366 elderly hypertensive population,there are 19 symptomatic elements of Yin deficiency related to 9 yin deficiency constitution,in 9 of them,OR value ismore than 2,in the meantime,17 symptomatic elements of Yang deficiency were related to yang deficiency constitution,9 of which,OR value is greater than 2.The simple identification table based on the WTT was used as the criterion,and the original research population was returned to Bayes discriminated analysis.The results showed that the sensitivity was 90.83%,the specificity was 97.67%,and the total coincidence rate was 95.63%.Among the 90 people,the sensitivity was 83.33%,the specificity was99.28%,the total coincidence rate was 95.35%.The simple identification table of senile hypertension Yin deficiency and yang deficiency was reliable.6.According to the risk factors of hypertension / Yin deficiency and yang deficiency,the relevant knowledge of health education was constructed by Delphi method.The positive coefficients of the experts were from 90% to 100%,and the coordination of expert opinions was good.Before and after educational intervention,100% of patients felt that they did not need to tell themselves all the contents.48% of the patients considered that 4-5 items were suitable for one time,while64.28% of the patients could accept 4 items or more.In the form of simple content education,the key element of the elderly canincrease the acceptance of key content.Conclusions1.Qi deficiency constitution,yin deficiency constitution and yang deficiency constitution were the most common constitutions in elderly hypertensive patients.2.Biased constitution is influenced by gender and course of disease.Physical type,sex and age can affect the clinical characteristics of elderly patients with chronic diseases(hypertension).3.High correlation is found between the 9 Yin deficiency symptomatic elements and yin deficiency,and the same with 9Yang deficiency symptomatic elements are strongly associated with Yang deficiency.Based on this,a simple identification table of yin deficiency and yang deficiency in the elderly chronic diseases(hypertension)population is made.4.The TCM health education mode for elderly patients with chronic diseases(hypertension)was established and verified clinically.The effect of key health education is better than that of non-focused(general)health education. |
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