| Research objectivesThrough investigation and analysis of the second affiliated hospital of tianjin medical university hypertension with blood lipid levels in patients with abnormal blood pressure,blood lipid,related factors(age,gender,smoking history,BMI,etc.)with their respective constitutional classification,to explore the health category of primary hypertension patients with dyslipidemia,the classification of the early intervention by physical identification,to cause disease syndrome differentiation to provide clinical basis for intervention in the disease,upgrade the level of clinical treatment and provide support for effective comprehensive constitution of TCM prevention.Research methodsThis study selected the January 2019-February 2021 in the second affiliated hospital of tianjin medical university during the period of cardiology ward and outpatient clinic of 223 patients with primary hypertension with dyslipidemia,through collected in the form of questionnaire and basic physical and chemical inspection of the object of study of the basic information(age,gender,blood pressure,heart rate,smoking history,tongue and pulse condition),biochemical examination(triglyceride(TG),serum total cholesterol(TC),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C)),body mass index(BMI),The above indexes were recorded and analyzed.Logistic regression analysis and other statistical analysis were conducted with SPSS22.0 software to study the correlation between the indexes of patients with essential hypertension complicated with dyslipidemia and the distribution of TCM constitutions.Research results1 There were 114 males(51%)and 109 females(49%)in 223 patients,the ratio of male to female was 1.04:1;the age ranged from 26 to 67 years old,with an average age of 48.13 ± 7.96 years old.There was no significant difference in gender based age groups among patients who met the inclusion criteria(P = 0.313 > 0.05);there were significant differences in smoking history and drinking history between male and female patients(P < 0.01);2 A total of 52 types of constitution were found in 223 patients.In single constitution,22 cases(9.87%)were phlegm dampness constitution,19 cases(8.52%)were damp heat constitution,and 17 cases(7.62%)were qi stagnation constitution.In mixed constitution,32 cases(14.35%)were phlegm dampness constitution combined with damp heat constitution,22 cases(9.87%)were Qi deficiency combined with phlegm dampness constitution,and 16 cases(7.17%)were Qi deficiency combined with qi stagnation constitution,The proportion of these six constitutions is the highest,which is the main category of this study.3 There were significant differences among the six constitutions,gender and age(P < 0.05,P < 0.01).Men tend to have phlegm dampness combined with damp heat,Qi deficiency combined with phlegm dampness,while women tend to have qi stagnation,Qi deficiency combined with qi stagnation.According to the age study,the single constitution tends to the middle-aged people aged 40-49,while the mixed constitution tends to the middle-aged people aged 50-59,and the Qi deficiency constitution and phlegm dampness constitution tend to the middle-aged people aged 40-49.The proportion of young people aged 20-39 with single constitution was 27.59%,and the proportion of middle-aged and old people aged 40-69 was72.41%;while the proportion of young people with mixed constitution was 4.29%,and the proportion of middle-aged and old people was 95.71%.4 In the study of the relationship between the main six constitutions and BMI,the difference was statistically significant(P < 0.01).The highest average BMI of phlegm dampness combined with damp heat was 28.47 ± 3.07kg/m2,and the lowest average BMI of qi stagnation was 22.74 ± 1.67kg/m2.The overall average body shape from fat to thin was phlegm dampness combined with damp heat > Qi deficiency combined with phlegm dampness > damp heat > phlegm dampness > Qi deficiency combined with qi stagnation > qi stagnation.Phlegm dampness constitution and its mixture constitution had the largest number of degree 1 and 2obesity,while qi stagnation constitution and its mixture constitution had the largest number of normal BMI.5 There were statistically significant differences between the six constitutions and smoking history,drinking history,family genetic history(P < 0.05).The number of drinking history and family genetic history of patients with phlegm dampness and damp heat was similar,and the two factors were higher than smoking history;the proportion of patients with qi depression had family genetic history was very high(76.47%);the proportion of patients with phlegm dampness and damp heat was very high,Among the patients with Qi deficiency syndrome and phlegm dampness syndrome,77.27% had family genetic history,and 93.75% had family genetic history.On the whole,the proportion of risk factors of mixed constitution(especially phlegm dampness combined with dampness heat,Qi deficiency combined with phlegm dampness)is significantly higher than that of single constitution.6 In the study of the Constitution and blood pressure of 223 patients in the whole sample,both SBP and DBP are non normal distribution,102 patients with simple SBP hypertension,accounting for 45.73%;8 patients with simple DBP hypertension,accounting for 3.59%;113 patients with elevated SBP and DBP,accounting for 50.67%.The average value of SBP was the highest in patients with phlegm dampness and damp heat,and the lowest in patients with qi stagnation;the average value of DBP was the highest in patients with damp heat,and the lowest in patients with qi stagnation.From the single constitution and mixed constitution,mixed constitution is generally higher than the average SBP of single constitution.7 Study on the Constitution and blood pressure classification of 223 patients in the whole sample,103 cases(46.19%)were grade 1 hypertension(mild),106 cases(47.53%)were grade 2 hypertension(moderate),and 14 cases(6.28%)were grade3 hypertension(severe).There were significant differences between the six constitutions and blood pressure grades(P < 0.01).The number of people with grade 1 hypertension in Qi stagnation constitution,Qi deficiency constitution and qi stagnation constitution was the largest;the number of people with grade 1hypertension in Qi deficiency constitution and phlegm dampness constitution was the same as that in grade 2 hypertension;the number of people with grade 2hypertension in phlegm dampness constitution,dampness heat constitution and phlegm dampness constitution and dampness heat constitution was the largest.8 In the study of the Constitution and blood lipid of 223 patients in the whole sample,the four levels of blood lipid are non normal distribution.There were 28 cases of simple abnormal TC,50 cases of simple abnormal TG,11 cases of simple abnormal LDL-C,7 cases of simple abnormal HDL-C,39 cases of TC combined with abnormal TG,3 cases of TC combined with abnormal LDL-C,6 cases of TC combined with abnormal HDL-C,2 cases of TG combined with abnormal LDL-C,3 cases of TG combined with abnormal HDL-C,8 cases of TC and TG combined with abnormal LDL-C,1 case of TC and TG combined with abnormal HDL-C,0case of TC and LDL-C combined with abnormal HDL-C There were 7 cases of abnormal TG,LDL-C and HDL-C,and 55 cases of abnormal four indexes.The difference between the six constitutions and the types of dyslipidemia was statistically significant(P < 0.05).The main types of qi stagnation,Qi deficiency and qi stagnation were abnormal TG;the main types of phlegm dampness,dampness heat,Qi deficiency and phlegm dampness,phlegm dampness and dampness heat were mixed dyslipidemia,especially phlegm dampness and dampness heat.The proportion of mixed dyslipidemia was very high(71.88%).9 By multivariate logistic regression analysis,through the analysis of age,gender,smoking,drinking,fat and thin,family history for three types of single constitution(phlegm dampness,dampness heat,qi stagnation),phlegm dampness and dampness heat tend to male,qi stagnation tend to female;age has no significant bias;phlegm dampness and dampness heat tend to patients with drinking history,while dampness heat tend to female The results showed that the tendency of hot drinking was the largest;the tendency of smoking was not obvious;the patients with qi stagnation tended to be normal body type,and the patients with damp heat tended to be overweight;the patients with qi stagnation had obvious family history tendency.Research conclusion1 The age distribution of patients with essential hypertension complicated with dyslipidemia has nothing to do with gender;the constitution of patients is related to age,gender,BMI index,smoking history,drinking history,family genetic history and other risk factors.2 Patients with essential hypertension complicated with dyslipidemia mainly have six constitutions: phlegm dampness,dampness heat,qi stagnation,phlegm dampness combined with dampness heat,Qi deficiency combined with phlegm dampness,Qi deficiency combined with qi stagnation.The six groups should pay more attention to the prevention and control of hypertension.3 In patients with essential hypertension complicated with dyslipidemia,phlegm dampness constitution and its mixed constitution are the main constitution in men,and qi stagnation constitution and its mixed constitution are the main constitution in women.The singleness of constitution is related to mixed constitution and age.Young people tend to single constitution,and middle-aged and old people tend to mixed complex constitution.4 Most of the patients with essential hypertension complicated with dyslipidemia are overweight and obese.The highest BMI values are phlegm dampness combined with damp heat,phlegm dampness and damp heat,while the lowest BMI index is in Qi stagnation.5 The patients with essential hypertension and dyslipidemia are mostly grade 1 and grade 2 hypertension.Qi stagnation constitution,Qi deficiency constitution and qi stagnation constitution are mainly grade 1 hypertension.Qi deficiency constitution and phlegm dampness constitution have the same number of grade 1 and 2hypertension.Phlegm dampness constitution,dampness heat constitution,dampness heat constitution and phlegm dampness constitution are mainly grade 2hypertension.6 In patients with essential hypertension and dyslipidemia,TG,TC and LDL-C are the main four dyslipidemia.Qi stagnation,Qi deficiency and qi stagnation are mainly abnormal TG;phlegm dampness,dampness heat,Qi deficiency and phlegm dampness are mainly mixed dyslipidemia;phlegm dampness and dampness heat are almost all mixed dyslipidemia.Men tend to have phlegm dampness constitution and its mixture constitution,while women tend to have qi stagnation constitution and its mixture constitution.7 Age has no significant bias to constitution;constitution has obvious gender bias,BMI has obvious bias to constitution;smoking history has no obvious bias;drinking history has bias to phlegm dampness and dampness heat;family history has obvious bias to patients with qi depression. |
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