Correlation Study Of Different TCM Syndromes Of Hypertension With Echocardiography And Ballistic Cardiogram

Background:Essential hypertension is a progressive cardiovascular syndrome,often accompanied by structural and/or functional damage to the heart,brain,blood vessels and kidney and other target organs.It is characterized by high prevalence,younger onset and an increasing trend year by year,and has become one of the important risk factors for cardiovascular diseases.With the further study of its pathogenesis and treatment in modern medicine,it is found that TCM has certain advantages in improving the clinical symptoms and stabilizing blood pressure of patients with hypertension.Many years of clinical medical practice has proved that TCM has a significant effect on the prevention and treatment of hypertension,but it has not formed a complete syndrome differentiation system.Therefore,the objective quantitative basis for the exploration of TCM syndrome differentiation is of great significance for improving the TCM syndrome differentiation level and clinical efficacy of hypertension.With the development of modern medicine,it has become one of the new research hotspots to link the modern examination methods with the TCM syndrome types of hypertension,aiming to improve the standardization of TCM syndrome differentiation and further improve the clinical treatment effect.Ultrasonic cardiogram is a non-invasive means of examination for the heart and large blood vessels,which is of great clinical significance for the evaluation of cardiac structural and functional changes in patients with hypertension.As is a new type of cardiovascular disease detection instrument,BCG has been proved to be of great value in cardiovascular diseases such as coronary heart disease,heart failure and hypertension.Therefore,this study aims to combine ultrasonic cardiogram with BCG,in order to futher study on hypertension of different TCM syndrome types with ultrasonic cardiogram and the correlation of BCG,to provide objective quantitative basis and clinical guidance for TCM syndrome differentiation,and to provide new ideas and data support for the study and clinical application of BCG.Objectives:1.To study the differences between the hypertension group and the non-hypertension group in terms of ultrasonic cardiogram with BCG,and explore the feasibility of studying hypertension.2.To study the differences and correlations between different TCM syndrome types,ultrasonic cardiogram and BCG in the hypertension group,so as to provide objective quantitative indicators for TCM syndrome differentiation,and improve the level of TCM syndrome differentiation and clinical efficacy of hypertension.3.To study the correlation between ultrasonic cardiogram related indicators and BCG,and explore the feasibility of BCG to study the structural and functional changes of hypertensive heart.Methods:A total of 180 patients diagnosed as essential hypertension in the cardiovascular department ward and outpatient department of Oriental Hospital of Beijing University of Chinese Medicine from April to November 2019 were included in the hypertension group,and 50 patients with coronary heart disease,hypertension,acute and chronic heart failure,severe arrhythmia and other diseases were excluded in the non-hypertension group.The western medicine diagnostic criteria were referred to the 2018 revision of Chinese guidelines for the prevention and treatment of hypertension.TCM syndrome differentiation and classification were summarized by referring to the Guiding Principles for Clinical Research of New Chinese Medicines(Trial)issued in 2002 and clinical practice experience,which were divided into 5 syndromes:liver fire hyperactivity syndrome,excessive accumulation of phlegm dampness syndrome,Yin deficiency and Yang hyperactivity syndrome,qi deficiency and blood stasis syndrome,Yin and Yang deficiency syndrome.All patients were enrolled into the hypertension group and the non-hypertension group respectively according to the Inclusion and exclusion criteria by physicians at the deputy director level or above;Patients in the hypertension group were then diagnosed with TCM syndrome differentiation by two TCM physicians at the deputy director level or above according to the four diagnostic data,and those who met the criteria were respectively included in the corresponding TCM syndrome type group.The enrolled patients were recorded and collected by the researchers in terms of BCG signal collection and ultrasonic cardiogram data.All the data of the above observation indicators were processed with SPSS20.0 statistical software.Results:1.A total of 180 patients in the hypertension group and 50 patients in the non-hypertension group were included in this study.There was no significant statistical difference in age,gende and other general information between the groups(p>0.05).2.There were significant differences in the distribution of IVS,LVM,LVMI and LVEF values between the hypertension group and the non-hypertension group(p<0.05).The values of IVS,LVM and LVMI in the hypertension group were significantly higher than those in the non-hypertension group.while the values of LVEF were significantly lower than those in the non-hypertension group.3.There were significant differences in the distribution of H,I,J,K,tHI,tIJ and tJK values in BCG between the hypertension group and the non-hypertension group(p<0.05).The H,I,J and K wave values in the hypertension group were significantly lower than those in the non-hypertension group,and the tHI,tIJ and tJK values in the hypertension group were significantly higher than those in the non-hypertension group.4.There were significant differences in the distribution of IVS,LVM,LVMI and LVEF values between TOM syndromes in the hypertension group(p<0.05).According to the decrease of IVS value,the syndrome types were successively as follows:excessive accumulation of phlegm and dampness>Yin and Yang deficiency syndrome>qi deficiency and blood stasis syndrome>liver fire hyperactivity syndrome>Yin deficiency and Yang hyperactivity syndrome.According to the decrease of LVM and LVMI value,the syndrome types were successively as follows:Yin and Yang deficiency syndrome>excessive accumulation of phlegm and dampness>qi deficiency and blood stasis syndrome>liver fire hyperactivity syndrome>Yin deficiency and Yang hyperactivity syndrome.According to the decrease of LVEF value,the syndromes were successively as follows:liver fire hyperactivity syndrome>excessive accumulation of phlegm and dampness syndrome>Yin deficiency and Yang hyperactivity>qi deficiency and bloord stasis syndrome>Yin and Yang deficiency syndrome.The results of multiple comparisons between groups showed statistically significant differences(p<0.05).5.There were significant differences in the distribution of the H,I,J and K wave values of the main indexes of BCG among different TCM syndroms in the hypertension group(p<0.05).According to the decrease of H,I,J and K value,the syndrome types were successively as follows:liver fire hyperactivity syndrome>excessive accumulation of phlegm and dampness syndrome>Yin deficiency and Yang hyperactivity syndrome>qi deficiency and blood stasis syndrome>Yin and Yang deficiency syndrome.The results of multiple comparisons between groups showed statistically significant differences(p<0.05).6.There were significant differences in the distribution of tHI and tIJ values in the main indexes of TCM syndrome types in the hypertension group(p<0.05).According to the decrease of tHI value,the syndrome types are successively as follows:Yin and Yang deficiency syndrome>qi deficiency and blood stasis syndrome>Yin deficiency and Yang hyperactivity syndrome>excessive accumulation of phlegm and dampness syndrome>liver fire hyperactivity syndrome.According to the decrease of tIJ value,the syndrome types were successively as follows:Yin and Yang deficiency syndrome>qi deficiency and blood stasis syndrome>Yin deficiency and Yang hyperactivity syndrome>liver fire hyperactivity syndrome>excessive accumulation of phlegm and dampness syndrome.The results of multiple comparisons between groups showed statistically significant differences(p<0.05).There was no significant difference in the distribution of tJK value between TCM syndromes in hypertension group(p>0.05).7.TCM syndromes of hypertension are correlated with H,I,J,K,tHI,tIJ,LVM,LVMI and LVEF values.With the changes of TCM syndromes,tHI,tIJ,LVM and LVMI increased gradually,while H,I,J,K and LVEF decreased gradually.No correlation between TCM syndromes of hypertension and IVS was found.8.Objective indexes(IVS,LVM,LVMI,LVEF)used to evaluate the structure and function of hypertensive heart in ultrasonic cardiogram have a certain correlation with the main indexes(H,I,J,K,tHI,tIJ,tJK)of BCG.Conclusions:1.There were significant differences in the distribution of ultrasonic cardiogram related indicators(IVS,LVM,LVMI,LVEF)between the hypertensive group and the non-hypertensive group,indicating the feasibility of ultrasonic cardiogram in the study of hypertension.2.There were significant differences in the indexes H,I,J,K,tHI,tIJ and tJK of the hypertension group and the non-hypertension group,which proved that the BCG was feasible for the study of hypertension.3.There are significant differences between different TCM syndromes and ultrasonic cardiogram related indexes(IVS,LVM,LVMI,LVEF)and BCG indexes(H,I,J,K,tHI,tIJ),which can provide objective quantitative indexes for TCM syndrome differentiation of hypertension.4.TCM syndrome types are correlated with H,I,J,K,tHI,tIJ,LVM,LVM,and LVEF values to some extent,indicating that ultrasonic cardiogram and BCG can provide objective reference for TCM syndrome differentiation and deficiency and empirical evidence.5.The objective indexes used to evaluate the structure and function of hypertensive heart in ultrasonic cardiogram are correlated with BCG,which indicates that BCG has the feasibility to study the changes of the structure and function of hypertensive heart.