Relationship Between TCM Syndromes Of Left Ventricular Hypertrophy And Left Ventricular Structure Index And Traditional Chinese Medicine Intervention

Hypertension is a common and frequently encountered disease in the cardiovascular system,having different degree of damages to general target organs.Hypertensive left ventricular hypertrophy(LVH) is the earliest performance of heart ventricular remodeling,and independent risk factors for cardiovascular events.Therefore,we should emphasis on the hypertensive LVH,to prevent and reversal target-organ damages which are caused by hypertension,to improve the prognosis of patients.This study aims at through retrospective study of clinical cases,discussing the characteristics of TCM syndrome type distribution,influence factors of LVH,and relations with echocardiography structure indicators,while combined with animal experiments to evaluate the effectiveness of TCM in hypertensive LVH,so as to provide some references for clinical syndrome differentiation treatment in hypertensive LVH,and prevent the occurrence and development of cardiovascular diseases which are caused by hypertension. This essay mainly includes the following three aspects:1 Theoretical studyThrough reviewing relevant literature, give the overview of modern medicine and traditional Chinese medicine research progress and understanding of hypertensive left ventricular hypertrophy,to provide theoretical basis for clinical diagnosis and treatment.2 Clinical research2.1 ObjectiveThrough the clinical observation of general,hypertension characteristics,and echocardiography structure indicators of left ventricle in hypertension patients with left ventricular hypertrophy, to explore the TCM syndrome type distribution of this disease, in addition to provide references in clinical diagnosis,syndrome differentiation treatment of hypertensive left ventricular hypertrophy, while prevent the developments of cardiovascular diseases which are caused by this disease.2.2 MethodsUsing the retrospective clinical study.124 cases of hypertension patients with left ventricular hypertrophy in Guang’an men Hospital from Oct.2010 to Oct.2014 were involved in this study.This research was mainly contented on the patients’general situation, hypertension situation,TCM syndrome types,echocardiography structure indicators,etc.Using Excel software to establish the database,then using SPSS17.0 statistical software for statistical analysis.2.3 Results2.3.1 General characteristics:Among the 124 hypertension patients with left ventricular hypertrophy,79 are male(63.7%),45 are female(36.2%).Their age are from 40 to 80,with an average age of 66.32±9.56 years old.The courses of hypertension are from one year to 50 years,with an average duration of 15.36±10.15 years.From BP levels part,20(16.1%) in grade 1,39(31.5%) in grade 2,65(52.4%) in grade 3.From risk stratification part,5(4.0%) with low added risk,4(3.2%) with moderate risk,25(20.2%) with high risk,90(72.6%) with very high risk.2.3.2 The distribution of TCM syndrome type and influenced factors:The proportion of four main TCM syndrome type is:qi-yin asthenia syndrome>phlegm dampness syndrome>yin deficiency yang hyperactivity syndrome>yin yang concurrent deficiency syndrome;94(75.8%) have Blood stasis syndrome.Gender affects the distribution of main syndrome type, and the proportion of yin deficiency yang hyperactivity syndrome and yin yang concurrent deficiency syndrome in male is large than women.Most of the patient with yin deficiency yang hyperactivity syndrome have a history of smoking; And most of the patient with phlegm dampness syndrome have a history of drinking.In terms of duration of hypertension,patients with yin yang concurrent deficiency syndrome are longest,while with yin deficiency yang hyperactivity syndrome are shortest.2.3.3 Echocardiography structure indicators and influenced factors:Left ventricular posterior wall thickness and left ventricular mass increase obviously in male than female. Patients older than 60 years, the more apparent in left ventricular mass increase. Patients with a history of smoking or drinking,echocardiography index change is more obvious.With the increase of hypertension duration and risk stratification, the left ventricular mass index is increasing.2.3.4 The relationship between echocardiography structure indicators and TCM syndrome typeFour main TCM syndrome type have no significant differences in left ventricular end-diastolic diameter.The indicators of end-diastolic interventricular septum thickness,left ventricular posterior wall thickness,left ventricular mass and left ventricular mass number in patients with yin yang concurrent deficiency syndrome are higher than other three syndromes.The indicators of end-diastolic ventricular septal thickness and left ventricular mass index are significantly increased in patients with blood stasis syndrome.2.4 ConclusionsHypertensive left ventricular hypertrophy is affected by age,gender, duration of hypertension and risk stratification.Left ventricular configuration changes prominently in patients with yin yang concurrent deficiency syndrome,while the process of left ventricular hypertrophy is more significant.Patients with this disease should early and regular take antihypertensive drugs,that can control development process.The treatment of combining zheng differentiation-treatment with activating blood circulation-treatment can increase the curative effect, improve the prognosis of patients.3 Experimental research3.1 ObjectiveObserving changes of left ventricular myocardial ultrastructure in SHR,to investigate the pathological characteristics of hypertensive left ventricular ultrastructural,and evaluate the effectiveness of Tianmashuxin in hypertension-theraphy..3.2 Methods80 male SHR were randomly divided into model group, western medicine group,high,middle and small dose of Tianmashuxin treat-group,with 16 rats in each group,while 15 WISTAR were used as normal control group. They were given different doses of Tianmashuxin extract liquid, losartan potassium tablets suspension and distilled led water once a day.After 18 weeks,we used transmission electron microscopy to observe changes of myocardial ultrastructure.3.3 ResultsCompared with normal control group,the damage of myocardial ultrastructure in model group was apparented.Compared with model group, the myocardial ultrastructure of three Tianmashuxin groups were improvements.High dose group compared with middle and low dose group improved more significantly.3.4 ConclusionsHypertension can cause damages of myocardial ultrastructure.The pathological features are fractured,dissolved,distortion and thicknesses of myocardial fibers,while swelling,deformation and gathered of mitochondria. Tianmashuxi can effectively improve the damage of hypertensive myocardial ultrastructure.