Study On TCM Syndrome And Medication Regularity Of Patients With Hypertension And Insomnia

ObjectiveAt present,hypertension is a common chronic disease.Studies at home and abroad have found that hypertension is an important cause of sleep disorders,and the incidence of primary hypertension comorbidity insomnia is as high as50%.On the contrary,insomnia will lead to increased blood pressure in patients.At present,hypertension combined with insomnia are common chronic diseases.The incidence rate of it is gradually rising.The incidence of primary hypertension comorbidity insomnia is more than 50%.Studies at home and abroad have found that hypertension is an important cause of sleep disorders,on the contrary,insomnia will lead to increased blood pressure,the two are cause and effect each other.Compared with western medicine,traditional Chinese medicine has the unique advantages of less toxic and side effects and relieving symptoms.It is the so-called "one side of water and soil nourishes one side of people".Currently,there is still a lack of research on TCM syndromes and medication rules of hypertension combined with insomnia in Lingnan area.The purpose of this study is to explore the distribution of TCM syndromes and medication rules of patients with hypertension and insomnia in Lingnan area,so as to provide reference for TCM treatment of hypertension and insomnia.Methods In this study,prospective research method was adopted.Patients with hypertension and insomnia who were hospitalized or outpatients in the First Affiliated Hospital of Guangzhou University of traditional Chinese medicine from June 2020 to February 2021 were selected as the research objects.The basic information,insomnia degree evaluation,combined diseases,target organ damage,information on the four diagnosis of traditional Chinese medicine and other related data of all patients on the day of admission were recorded,and the database containing TCM Syndrome Types and clinical information of hypertension combined with insomnia was constructed.With the support of SPSS25.0 software and platform of“traditional Chinesemedicine inheritance(v2.5)”,the clinical characteristics,TCM syndrome differentiation and medication rules of all patients with hypertension and insomnia were statistically analyzed.Results1.Basic characteristics: a total of 100 patients were included in this study.The age of patients ranged from 30 to 90 years old,with an average age of 59.45±12.829 years old.There were 40 males with an average age of59.4512.829 years and 60 females with an average age of 62.15±11.440 years.This study shows that 50-79 years old patients are the majority of patients with hypertension and insomnia.The ratio of male to female was 1:1.5,women are more than men.By chi square test,there was no significant difference in gender distribution among different age groups of patients with hypertension and insomnia(P>0.05).2.Course of hypertension,classification,risk stratification of hypertension and severity of insomnia: the shortest course of hypertension was 1 month,the longest was 30 years,and the mean standard deviation of course was 6.445±6.294 years.There were 11 cases of grade 1 hypertension,36 cases of grade 2 hypertension and 53 cases of grade 3 hypertension.There were 5cases in low risk group,22 cases in medium risk group,11 cases in high risk group and 62 cases in very high risk group.The severity of sleep was "very good" in 0 cases,"good" in 67 cases,"average" in 28 cases and "very poor" in 5 cases.The higher the grade of hypertension,the more risk factors,the more the number of hypertension with insomnia.Insomnia was mild.3.Factor analysis shows that the syndrome characteristics of hypertension with insomnia: the syndrome elements of the disease locations are mainly heart,liver and kidney,the main excess factors are heart and liver;the nature of syndrome elements are yang hyperactivity,blood deficiency,yin deficiency,fire[heat],Qi deficiency,phlegm and yang deficiency.The main nature of syndrome elements are yang hyperactivity,blood deficiency,yin deficiency and fire[heat].The common Characteristics of TCM syndromes are Yin deficiency and yang hyperactivity syndrome,Yin blood deficiency syndrome,heart-kidney imbalance syndrome,Qi and blood deficiency syndrome and phlegm-heat harassing the spirit syndrome.The main TCM syndromes were Yin deficiency and yang hyperactivity syndrome and Yin blood deficiency syndrome.4.Cluster analysis shows that the pattern elements of the disease locations of hypertension with insomnia are mainly heart,liver,kidney;the nature of pattern elements are blood deficiency,yin deficiency,yang hyperactivity,fire[heat];the main Characteristics of TCM patterns are yin deficiency and yang hyperactivity pattern,qi and blood insufficiency pattern,yin blood deficiency pattern.5.Medication rule:Analyzing the data based on the platform of "traditional Chinese Medicine Inheritance assistant support" to get the medication rule of hypertension combined with insomnia: 100 cases were included,with 100 prescriptions and 136 drugs in total.The frequency of common basic prescriptions from more to less were Erzhi Pill,Banxia Baizhu Tianma decoction,Tianma Gouteng Decoction,Suanzaoren Decoction and Wendan Decoction.The top four medication which prescribed were Ligustrum japonium(46),Gastrodia elata(46),Cocos(46),Chuanxiong(44).We found 12 drug combinations within 4 herbs which were the most common by the way of complex system entropy cluster and un-supervised hierarchical clustering composing principles.For example,"Hovenia dulcis,Bupleurum,Cyperus,Jessamine","Bamboo Shavings,Immature Bitter Orange,red tangerine peel and Coptis[root]","Gastrodia elata,Gardenia jasminoides,Cassia obtusifolia,Caulis Polygoni Multiflori","cortex rehmanniae,Eclipta,epimedium,licorice","semen Ziziphi Spinosae,Triticum aestivum,Anemarrhena asphodeloides,Polygala tenuifolia" and so on.ConclusionHypertension with insomnia is located in heart,liver and kidney.The most common syndromes were Yin deficiency and yang hyperactivity,Yin blood deficiency and Qi blood deficiency.It is suggested that the pathogenesis of hypertension combined with insomnia is the imbalance of yin and Yang.The treatment should be based on the principle of reinforcing deficiency and reducing excess,and adjusting Yin and Yang.The deficiency patients should nourish the liver and kidney,nourishing yin and blood,and Tonifying Qi and blood;the excess patients should calm the liver and latent Yang,clear away heat and phlegm,and soothe the liver and reduce fire.Most of them use the prescriptions of calming liver and suppressing yang,nourishing yin and blood,tonifying liver and kidney,tonifying qi and blood,supplemented by the prescriptions of clearing heat,resolving phlegm,calming nerves and soothing liver.