Clinical Investigation Research On Traditional Chinese Medicine Syndrome Composition Of Hypertension And Blood Lipid And Cardiac Structure And Function Changes

Objective:To study on the general distribution regularity of TCM syndrome composition of essential hypertension and different syndromes lipids in patients with essential hypertension,cardiac structure and function of changes in indicators,to provide a scientific basis for TCM of differentiation objective and treatment of standardized objective with essential hypertension.Methods:1.To design research form in TCM syndromes of hypertension according to the Guide Book of New TCM Pharmaceutic Clinical Research(2002 edition),fill in precise clinical materials.2.Two doctors in medium-grade or higher professional title make out syndrome differentiation according to the clinical materials.And collected by conventional make lipids in patients with hypertension,heart color Doppler ultrasound examination,recording blood lipids,heart color values of key indicators.3.After the end of the study to apply the SPSS13.0 software to do corresponding statistical treatment.Results:1.To arrange four TCM syndrome patterns of EH according to their constitute ratio in order:yin deficiency and yang hyperactivity syndrome＞excessive phlegm-dampness type＞liver-fire hyperactivity type＞yin deficiency and yang hyperactivity type＞yin-yang deficiency type.2.In terms of gender four TCM syndrome distribution had no significant statistical difference;and in regard of different age and course,liver-fire hyperactivity type and excessive phlegm-dampness are major patterns in middle-aged patients whose course of EH is short,yin-yang deficiency type is major pattern in old patients whose course of EH is long.3.The growth of systolic blood pressure(SBP) is apparent in the pattern of yin-yang deficiency type and more performance for the Systolic Hypertension,In systolic or diastolic blood pressure regardless of context,yin and yang deficiency type with other card-type has significant statistical difference;The increase of diastolic blood pressure(DBP) is conspicuous in the pattern of liver-fire hyperactivity type.4.The excessive phlegm-dampness type and the liver-fire hyperactivity type are major patterns in grade of 1,2 EH;the yin deficiency and yang hyperactivity type and the yin-yang deficiency type are major patterns in grade of 2,3 EH.The liver-fire hyperactivity type and the excessive phlegm-dampness type are major patterns in low risk group and medium risk group of EH.The yin deficiency and yang hyperactivity type and the liver-fire hyperactivity type are major patterns in high risk group.The yin-yang deficiency type is major patterns in very high risk group.The distribution of syndrome patterns of grades and risk strstifications of EH is also different. 5.Among the selected 300 cases of essential hypertension patients,there are 211 cases of patients with dyslipidemia,the total number of cases of 70.3%,of which the proportion of the excessive phlegm-dampness type is the most;have 62 cases of patients with hypertension combined left ventricular hypertrophy,the total number of cases of 20.6%,to the proportion of yin and yang deficiency type most;hypertension with abnormal cardiac function(EF＜50%) accounted for 18.3%,of which the proportion of yin and yang deficiency type most; hypertension with abnormal cardiac function(E/A＜1.0) accounted for 54.7%,of which the liver-fire hyperactivity type proportion of the majority.6.Hypertensive patients with different syndromes of total cholesterol(TC),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C) levels were significantly different(P＜0.01);hypertensive patients with different syndromes of glycerol Three ester(TG) level was no significant difference(P＞0.05).After further comparison,we can see that the excessive phlegm-dampness type hypertensive patients in term of total cholesterol,low density lipoprotein levels and other card-type were significantly different(P＜0.01).7.Hypertensive patients with different syndromes of left ventricular hypertrophy and cardiac function parameters have significantly different(P＜0.01).About parameters in left ventricular hypertrophy,the yin deficiency and yang hyperactivity type and yin-yang deficiency type have no significant difference(P＞0.05),most of the rest between syndrome types have significant differences(P＜0.01);about heart function parameters,a majority of the evidence type have the significant difference(P＜0.01),a small number of permits have no significant difference between type(P＞0.05).Conclusions:1.TCM syndrome of hypertension and changes in the distribution has a certain degree of regularity.2.The excessive phlegm-dampness type is the most widely in hypertension TCM distribution.3.The growth of systolic blood pressure(SBP) is apparent in the pattern of yin-yang deficiency type and more performance for the Systolic Hypertension;The increase of diastolic blood pressure(DBP) is conspicuous in the pattern of liver-fire hyperactivity type.4.The liver-fire hyperactivity type and the excessive phlegm-dampness type are major patterns in low hypertension classification and risk stratification;The yin-yang deficiency type and the yin deficiency and yang hyperactivity type are major patterns in high hypertension classification and risk stratification.Hypertensive patients of the yin-yang deficiency type are the most prone to major cardiovascular and cerebrovascular events.5.The increase of TC,LDL-C levels and the decrease of E/A value can be applied as the subjective index for among hypertensive patients of the excessive phlegm-dampness type;the increase of LDL-C can be applied as subjective index for among hypertensive patients of the yin deficiency and yang hyperactivity type;the decrease of EF value can be applied as subjective index for among hypertensive patients of the yin-yang deficiency type.6.Deficiency and empirical comparison,the cardiac damage in patients with hypertension have a tendency to increase.