Study On Quantitative TCM Differential Diagnosis Of Essential Hypertension

Objective: To quantify the results of ordinary clinical index,then define a formula to evaluateits clinical value in diagnosing different TCM syndromes of Essential Hypertension.Methods: 1. According to the Guide Book of New TCM Pharmaceutic Clinical Research（2002edition）, all patients were classified into 4 types:the Liver-Fire exuberant syndrome,thephlegm-dampness abundant,Yin-deficiency and yang-hyperactivity syndrome and Yin-yangdual deficiency syndrome. Then all patients of 4 types were classified into Xu and Shi types:Liver-Fire exuberant and the phlegm-dampness abundant labeled Shi,Yin-deficiency andyang-hyperactivity syndrome and Yin-yang dual deficiency syndrome labeled Xu.2. Appling the SPSS11.5 software and the approaches of discriminant, taking 4 types and XuShi types as grouping variable respectively, using stepwise method, displaying Fisher’s functioncoefficients,choosed Entry and Removal time after time, and the most efficient formulas andvalidation results was defined. The diagnostic efficiency of the formula in diagnosingsyndromes was evaluated by validate the background data.Results:1.The formulas of 4 types defined by discriminant:Y₁=-401.161+289.459X₃₀+283.644X₁₁₄-4.065X₁₁₅-4.773X₁₁₆+37.677X₁₃₇+2.572X₁₄₃-0.581X₁₄₈+1.032X₁₈₁+1.657X₂₀₂+1.887X₂₂₈;Y₂=-388.511+306.143X₃₀+241.429X₁₁₄-4.565X₁₁₅-5.857X₁₁₆+35.073X₁₃₇+1.574X₁₄₃-0.575X₁₄₈+1.101X₁₈₁-1.652X₂₀₂+2.119X₂₂₈;Y₃=-386.325+283.087X₃₀+271.961X₁₁₄-3.176X₁₁₅-4.387X₁₁₆+42.445X₁₃₇+1.037X₁₄₃-0.641X₁₄₈+1.045X₁₈₁-0.413X₂₀₂+2.239X₂₂₈;Y₄=-364.925+329.280X₃₀+174.998X₁₁₄-4.043X₁₁₅-6.172X₁₁₆+26.443X₁₃₇+1.503X₁₄₃-0.392X₁₄₈+0.915X₁₈₁-0.613X₂₀₂+1.141X₂₂₈Theindexes of diagnosis of EH: height (X₃₀), Hct (X₁₁₄), EAI (X₁₁₅), TK (X₁₁₆),apoal (X₁₃₇), urine IgG (X₁₄₃), ECG axis(X₁₄₈), 24 ABPM SBPmean night (X₁₈₁), Myocardialvelocity of lat basal segment(X₂₀₂), Myocardial distance of ing basal segment(X₂₂₈). Test of Wilk’s Lambda Functions display the Chi-square significance were 0.000 and theformula of 4 types were efficient. 92.7% of original grouped cases correctly classified.In crossvalidation, 89.0% of cross-validated grouped cases correctly classified.2. The formula of Xu and Shi types defined by discriminant:Y₁=-279.070-2.682X₈-7.582X₉₁+8.497X₁₁₂+4.127X₁₁₅+2.856X₁₁₆+3.709X₁₃₃+38.796X₁₃₇+11.759X₁₄₄+28.610X₁₆₀+0.476X₁₇₈+157.468X₁₈₆+6.265X₂₀₂+401.252X₂₂₅;Y₂=-245.121-0.009X₈+1.293X₉₁+4.515X₁₁₂+1.920X₁₁₅+1.540X₁₁₆+1.620X₁₃₃+28.836X₁₃₇+8.102X₁₄₄+12.995X₁₆₀+0.605X₁₇₈+187.937X₁₈₆+3.224X₂₀₂+349.327X₂₂₅The indexes of diagnosis of EH: education（X₈）, heart souffle(X₉₁), Highηb(X₁₁₂),EAI(X₁₁₅), TK (X₁₁₆),TG(X₁₃₃), apoal (X₁₃₇), TRF (X₁₄₄),premature ventricular beats (X₁₆₀),24 ABPM SBPmax(X₁₇₈),24 ABPM SBP d/n ratio (X₁₈₆), Myocardial velocity of lat basalsegment(X₂₀₂), Time of ant mid segment(X₂₂₅).Test of Wilk’s Lambda Functions display the Chi-square significance were 0.000 and theformula of Xu and Shi types were efficient. 100% of original grouped cases correctlyclassified.In cross validation, 98.8% of cross-validated grouped cases correctly classified.Conclusion:1. Based on the ordinary clinical data, a discriminatory function formula for quantitative TCMdifferential diagnosis was established by using the multivariate stepwise analysis model.2.The validation results of Xu Shi types and 4 types showed that the discriminatory functionformula for quantitative Xu and Shi diagnosis of EH possessed rather high diagnosticefficiency and was worthy of clinical use.