Correlation Between Traditional Chinese Medicine Syndrome Differentiation And Left Ventricular Hypertrophy In Patients With Essential Hypertension

Objective:Objective to explore the correlation between traditional Chinese medicine(TCM)syndrome differentiation of primary hypertension and left ventricular hypertrophy,and explore the left ventricular hypertrophy of hypertension from the perspective of TCM,and analyze the left ventricular hypertrophy and other test index of different syndrome types of primary hypertension.Methods: Total 267 patients with essential hypertension were investigated.According to the four diagnostic principles of traditional Chinese medicine,the patients were observed accurately and carefully,and the symptoms,pulse and tongue of the patients were recorded.General information(gender,age,medical history),homocysteine(Hcy),fasting blood glucose(Glu),triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)were collected.Then echocardiography was performed to collect relevant data,and left ventricular mass index was calculated according to Devereux formula.Results:(1)In this study,267 patients with essential hypertension were included,and the proportion from high to low was excessive phlegm dampness syndrome(32.2%);liver fire hyperactivity syndrome(26.6%);Yin deficiency and Yang hyperactivity syndrome(25.1%);Yin and Yang deficiency syndrome(16.1%).The number of patients with excessive phlegm dampness syndrome was the highest among the four syndromes.(2)Of the 267 cases collected,148 were male and 119 were female.The statistical results showed that the distribution of gender between different syndrome types was not statistically significant(P > 0.05).The age of the syndrome was significantly different(P < 0.05),the Yin and Yang deficiency syndrome’s average age was the largest,Yin deficiency and Yang hyperactivity syndrome was slightly greater than excessive phlegm dampness syndrome,and the liver fire hyperactivity was the least.There was no difference in height among different syndrome types(P >0.05).BMI and body weight were statistically significant among the syndrome types(P < 0.05).The biggest is the syndrome of liver fire hyperactivity,and the minimum is Yin and Yang deficiency.The course of disease was significantly different among the syndrome types(P > 0.05).The course of liver fire hyperactivity syndrome was significantly lower than that of the other three groups.(3)There was no significant difference between systolic pressure and heart rate(P > 0.05).The difference of diastolic pressure between different TCM syndromes(P < 0.05)was the highest,the highest was liver fire hyperactivity syndrome,and the lowest was Yin and Yang deficiency.The level of homocysteine(Hcy)was significantly different in different TCM syndromes(P < 0.05),the highest was Yin and Yang deficiency syndrome.TC and LDL-C also had statistical significance in each group(P < 0.05),TG and HDL-C were not statistically significant among the groups(P > 0.05).(4)There was no significant difference in the left ventricular end diastolic diameter,the thickness of the ventricular septum and the thickness of the left ventricular posterior wall between the different TCM syndromes(P > 0.05).The difference was statistically significant(P < 0.05).(5)104 patients with left ventricular hypertrophy were collected in this study.The syndrome types were from more to less,including 37 cases of excessive phlegm dampness syndrome,27 cases of Yin deficiency and Yang hyperactivity syndrome,23 cases of Yin and Yang deficiency syndrome and 17 cases of liver fire hyperactivity syndrome.The incidence rate of left ventricular hypertrophy in each group was statistically significant(P < 0.05),the highest incidence rate was 53.5%of Yin and Yang deficiency syndrome,and the lowest was 23.9% of liver fire hyperactivity syndrome.The difference of left ventricular weight index of different syndrome types was statistically significant(P < 0.05),from big to small,Yin and Yang deficiency syndrome,excessive phlegm dampness syndrome,Yin deficiency and Yang hyperactivity syndrome,liver fire hyperactivity syndrome.The correlation analysis of Spearman showed that age,course,Hcy and ejection fraction were correlated with left ventricular weight index(P < 0.05),among which age course and Hcy were positively correlated with left ventricular weight index,and ejection fraction was negatively correlated.BMI,blood pressure,heart rate,Glu,TC,TG,HDL-C and LDL-C were not correlated with the left ventricular weight index(P >0.05).Conclusion:(1)The most common TCM syndrome type of patients with essential hypertension is excessive phlegm dampness syndrome.(2)The average age of patients with Yin and Yang deficiency syndrome is the largest and the course of disease is the longest.The average age of hyperactivity of liver fire syndrome is the smallest and the course of disease is the shortest.The BMI of liver fire hyperactivity is the highest.(3)The patients with Yin and Yang deficiency syndrome had the highest Hcy level,while the patients with liver fire hyperactivity syndrome had the highest TC and LDL-C levels.(4)The ejection fraction of Yin and Yang deficiency syndrome was significantly lower than that of the other three syndromes.(5)The number of patients with excessive phlegm dampness syndrome is the most in left ventricular hypertrophy.Among all syndromes,the highest incidence rate of left ventricular hypertrophy is Yin and Yang deficiency syndrome.The largest left ventricular mass index is also Yin and Yang deficiency syndrome.Left ventricular mass index was positively correlated with age,course of disease and Hcy,and negatively correlated with ejection fraction.(6)Patients with Yin and Yang deficiency syndrome have the most serious condition of left ventricular hypertrophy.Active intervention should be taken to prevent more serious complications.The incidence of left ventricular hypertrophy in excessive phlegm dampness syndrome is the largest,and the incidence rate of left ventricular hypertrophy in excessive phlegm dampness syndrome is only less than Yin and Yang deficiency syndrome.The left ventricular hypertrophy of liver fire hyperactivity syndrome is lighter than that of other syndrome types,but some related risk factors are higher than that of other syndrome types,which may be due to the short duration of illness and the fact that the disease has not yet been transmitted.Therefore,it is necessary to treat the disease according to syndrome differentiation in time to prevent further development of the disease.