| Part I : Clinical investigation ObjectivesTo investigate the health-related quality of life in hypertensive patients, and to compare quality of life between the blood stasis syndrome and non-blood stasis one, and quality of life differences among the groups of hyperactivity of liver-yang syndrome, yin deficiency of liver and kidney syndrome, liver-wind and phlegm syndrome and deficiency of qi and yin syndrome. Analyze the related factors of blood stasis syndrome. MethodsHypertensive patients over the age of 18 years and below 75 years, attending outpatient clinics and inpatients of guang'an men hospital of general internal department were interviewed. The diseases types of the patierts were among hyperactivity of liver-yang syndrome, yin deficiency of liver and kidney syndrome, liver-wind and phlegm syndrome and deficiency of qi and yin syndrome. Hypertensive life assessment instrument established by professor Du xunming of Hubei medical university and questionnaire made by us. Trained doctors completed the questionnaire regarding demographics, treatment of history, symptoms, signs and quality of life issues and performed examination. Data were managed and statistically analyzed by software SPSS 11.5. Two-sample t test or the One-Way ANOVA tested normal distribution data. Non-normal distribution Data were tested by NPAR test , such as Mann-Whitney test, Kruskal — Wallis test, Chi-square analyses. ResultsA total of 324 hypertensive patients were enrolled;203(62.7%) had blood stasis syndrome. The result showed that blood stasis syndrome scored lower in multiple liner regression analyses in most questions on the quality of life questionnaire than those without blood stasis syndrome (P<0.05). Especially in some aspects like physiological symptoms, physical symptoms, sexual function,activity, anxiety, oppression, work performance and satisfaction, social participation, daily life quality and cognitive function (PO.05). Quality of life of the deficiency of qi and yin syndrome was the lowest among the four types of investigated syndromes that were hyperactivity of liver-yang syndrome, yin deficiency of liver and kidney syndrome, liver-wind and phlegm syndrome (PO.05). Scores of deficiency of qi and yin syndrome in some aspects such as physiological symptoms, physical symptoms, sexual function, activity, anxiety, oppression, work performance and satisfaction, social participation, daily life quality, cognitive function were lower than other groups (P<0.05). There was blood stasis syndrome in the four types of syndrome. But the degree of blood stasis was different, there was much more blood stasis in deficiency of qi and yin syndrome (PO.05). There were more coronary heart disease, angina pectoral, myocardial infarction, cerebral apoplexy and cerebral arteriosclerosis in qi and yin syndrome than others (PO.05). There were more risk factors like age, course of hypertension, obesity, history of cholesterol, and history of diabetes in blood stasis syndrome than non- blood stasis syndrome (PO.05). ConclusionsQuality of life in blood stasis syndrome is lower than those without blood stasis syndrome. Blood stasis is one of the most important pathogenesis in hypertension. It is very important that hypertension is treated with promoting blood circulation to remove blood stasis on the basis of determination of treatment based on differentiation of syndromes. Which is new notion of traditional Chinese medicine to improve the quality of life for the hypertensive patients.Part II: Clinical study ObjectivesTreating the hypertensive patients who are liver-wind and phlegm syndrome with promoting blood circulation to remove blood stasis on the basis of determination of treatment based on differentiation of syndromes, in order to explore the therapeutic effect of quality of life, symptoms and signs.MethodsA total of sixty hypertensive patients over the age of 18 years and below the age of 75 years with liver-wind and phlegm syndrome were randomized into treated group(n=30) and control group(n=30).The treated group were treated with herbal decoction named xihuayin II (treating principle is tranquilizing endogenous wind and dispelling phlegm combined with promoting blood circulation to remove blood stasis ), the control group patient were distributed with herbal decoction named xihuayin I (treating principle is tranquilizing endogenous wind and dispelling phlegm). The therapeutic course was 4 weeks. Scores of quality of life were collected before and after treatment, Scores of symptoms and signs were collected every week. Side and toxic reactions were recorded. Data were managed and statistically analyzed by SPSS 11.5. Two-sample t test or the One-Way ANOVA tested normal distribution data. Non-normal distribution Data were tested by NPAR test, such as Mann-Whitney test, Kruskal—Wallis test, Chi-square and analyses. ResultsWhen the course ended, two groups's total scores on quality of life (higher is better) (P<0.05) increased, the scores on symptoms and signs (lower is better) (P<0.05) decreased. There were significantly differences between two groups (PO.05), the effect of the treated group was better than the control group. The treated group could significantly improve the scores of quality of life in some aspects like physiological symptoms, physical symptoms, sexual function, activity, anxiety, oppression, work performance and satisfaction, social participation, daily life quality, cognitive function. Scores of the symptoms and signs of treated group were lower than the control group after the treatment (PO.05). Some symptoms and signs like dizziness, headache, dim eyesight, constriction in chest, pain in the chest, were improved significantly and the treated group was better than control group (PO.05). No important Side and toxic reactions were found in two groups. ConclusionsDcreasing blood pressure effectively and improving the quality of life are the aim of hypertension treatment. The treatment of promoting blood circulation toremove blood stasis on the basis of determination of treatment based on differentiation of syndromes can decrease blood pressure, improve symptoms and signs, improve quality of life, which is a new notion for the hypertension treatment of traditional Chinese medicine. |
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