Regional Distribution Of TCM Syndrome Types Of Hypertension In Shandong Province

Objective: Questionnaire was used to investigate the distribution characteristics and rules of TCM syndrome types of hypertension patients in hospitals in Eastern,central and western Shandong Province.To explore the differences in gender,BMI,family history of hypertension,work type,marriage,education level,smoking,drinking,sleep quality,highsalt diet,TCM syndrome type and constitution between young and middle-aged hypertension and elderly hypertension,and to study the risk factors affecting hypertension in young and middle-aged hypertension and elderly hypertension.To provide reference for prevention and treatment of hypertension in different age stages.Methods: This study on disease of heart head blood-vessel of clinical medicine of traditional Chinese medicine research center of shandong province in 2018 approved to carry out the "normal high value and hypertension TCM syndrome types in the research of the distribution regularity and suitable for high technical intervention normal value of traditional Chinese medicine efficacy evaluation research" topic of normal high value and hypertension syndromes learn evidence-based research,adopt the method of data mining,Based on the Affiliated Hospital of Shandong University of Traditional Chinese Medicine,a total of 600 patients with hypertension who were hospitalized in 10 cooperative hospitals in Eastern,central and western Shandong from August 2020 to February 2021 were selected as the research objects.In shandong province,98 cases were reported in Penglai Hospital of Traditional Chinese Medicine,47 in Haiyang Hospital of Traditional Chinese Medicine,23 in Qixia Hospital of Traditional Chinese Medicine,45 in Laiyang Hospital of Traditional Chinese Medicine,83 in Yantai Hospital of Traditional Chinese Medicine,58 in Dongying Fifth People’s Hospital and 89 in Qingdao Hospital of Traditional Chinese Medicine.There were 30 cases in Zibo Hospital of Traditional Chinese Medicine and 76 cases in the Third Affiliated Hospital of Shandong First Medical University.A total of 51 cases were collected from The People’s Hospital of Eping District,Liaocheng City.All cases were selected according to the inclusion and exclusion criteria.According to the "China Statistical Yearbook" of National Bureau of Statistics since2000,using 65 years old as the starting age for the definition of elderly population,600 cases were divided into two groups: young and middle-aged hypertension group under 65 years old,and elderly hypertension group 65 years old and over.The patients’ age,gender,BMI,family history of hypertension,salt intake and other general information were statistically analyzed,according to the four TCM diagnosis criteria of hypertension established by the research group on the basis of the Guidelines for Clinical Research of Traditional Chinese Medicine New Drugs(2002 edition).Hypertension can be divided into Yin hand syndrome,phlegm and blood stasis and knot,something on inflammation and kidney deficiency syndrome,exploration in the eastern shandong,shandong,luxi region hypertension TCM syndrome type distribution,examine the different characteristics of the two groups of high blood pressure,an independent risk factor of relevant factors analysis and Logistics regression analysis,and finally provides the theoretical basis for prevention and treatment of hypertension.Results: 1.Distribution of TCM syndrome types of hypertension in shandong Province: In Eastern Shandong province,the syndrome of phlegm and blood stasis was the main one,accounting for 42.4%;In central Shandong province,Yin deficiency and Yang hyperactivity were predominant,accounting for 34.0%.In western Shandong,the syndrome of phlegm and blood stasis was the main one,accounting for 41.2%.After multiple tests,compare the regional adjusted standardized residuals to determine differences in eastern with phlegm and blood stasis after adjustment of the standardized residual error is 3.6,and getting very phlogistic card adjusted standardized residuals for 5.1,can be thought of in shandong province in eastern region of high blood pressure patients the TCM syndrome types tend to develop into each other by phlegm and blood stasis,And do not tend to develop into irascibility on inflammation syndrome.After adjustment,the standardized residual difference between central Shandong province and the syndrome of interaction of phlegm and stasis was-4.5,and the standardized residual difference between central Shandong Province and the syndrome of inflammation on liver fire was 6.2.It can be considered that the TCM syndrome type of hypertensive patients in central Shandong Province is more inclined to develop into the syndrome of inflammation on liver fire,but not the syndrome of interaction of phlegm and stasis.2.The overall distribution of TCM syndromes in the enrolled patients: from high frequency to low frequency: syndromes of phlegm and blood stasis(229/38.2%);Yin deficiency Yang hyperactivity syndrome(191/31.8%);Kidney qi deficiency syndrome(110/18.3%);Syndrome of inflammation on irascibility(70/11.7%).3.Differences in multiple factors between the young and middle-aged hypertension group and the elderly hypertension group: Gender(χ2=22.018,P < 0.01),family history of hypertension(χ2=6.353,P = 0.012 < 0.05),job type(χ2=73.578,P < 0.01),marriage(χ2=12.852,p < 0.01).P < 0.01),education level(χ2 was 69.711,P < 0.01),smoking(χ2=8.408,P = 0.004),alcohol consumption(χ2=11.256,P = 0.001),sleep quality(χ2=14.723,P =0.002 < 0.05),TCM syndrome type(χ2=11.004,P = 0.012 < 0.05),but there was no difference in BMI(P = 0.521,P > 0.05),high salt diet(χ2=0.129,P = 0.720 > 0.05)and body constitution(P =0.111,> 0.05).4.Main risk factors of hypertension in young and middle-aged group: The top five factors that had greater influence on the middle-aged and young hypertensive group were stable marriage OR 3.600(CL 1.483,8.742),mental work type OR 3.135(CL 1.828,5.377),syndrome of inflammation of liver fire OR 2.748(CL 1.443,5.233),A type of work that exists at the same time as both types of work OR 2.291(CL 1.382,3.799),junior high school OR above OR 2.097(CL 1.321,3.329).5.Main risk factors of the elderly hypertension group: The top four factors that have a greater impact on hypertension in the elderly hypertension group are: Physical labor OR2.493(CL 1.565,3.969),junior high school education OR 2.115(CL 1.339,3.340),good sleep quality OR 1.860(CL 1.294,2.673),female OR 1.566(CL 1.094,2.240).Conclusion: 1.The main TCM syndrome type of hypertension in eastern Shandong is the syndrome of interaction of phlegm and stasis;the main TCM syndrome type of hypertension in central Shandong is the syndrome of Yin deficiency and Yang hyperactivity;the main TCM syndrome type of hypertension in western Shandong is the syndrome of interaction of phlegm and stasis.The TCM syndrome type of hypertension in eastern Shandong tends to develop into the syndrome of mutual knot of phlegm and blood stasis,while the TCM syndrome type of hypertension in central Shandong tends to develop into the syndrome of irascibility and inflammation.Due to the different natural and social factors in the three regions,the distribution of TCM syndrome types is different.It accords with the thought of "correspondence between heaven and man" in Chinese medicine.Eastern Shandong is located in the coastal area,the climate is humid,the human body is vulnerable to the invasion of dampness,the body is prone to produce phlegm and dampness,the evil of phlegm and dampness damage blood collaterals over time,the blood flow is not smooth,the formation of stasis,finally the formation of phlegm and stasis mutual syndrome;Compared with the inland areas,the central area of Shandong province is less affected by coastal climate factors,and the inland heat is more prosperous,which makes human irascibility exuberant,and the syndrome of irascibility on inflammation is higher than that in eastern Shandong province.Eastern shandong and central Shandong have developed economy,people work under great pressure,nervous,and eating habits tend to be fatty and greasy products,the ability of self-regulation of the human body decreases,phlegm and blood stasis mutual syndrome and the proportion of liver fire on inflammation syndrome is high.2.The overall distribution of TCM syndromes of hypertension in Shandong Province: from high frequency to low frequency,the syndromes of phlegm and blood stasis interaction,Yin deficiency and Yang hyperactivity,kidney qi deficiency and liver fire inflammation.The proportion of the syndrome of mutual phlegm and stasis and the syndrome of Yin deficiency and Yang hyperactivity was the largest,indicating that the obstruction of phlegm and turbidness,stasis and blood stasis,the disturbance of liver fire and the hyperactivity of liver Yang were the etiology and pathogenesis of hypertension,while the deficiency of liver and kidney Yin was the internal cause of hypertension.Hypertension is closely related to liver,spleen and kidney.3.Gender: Male patients are in the majority in the young and middle-aged hypertension group,while female patients are in the majority in the elderly hypertension group.With the aging of age,the number of female patients is more than male.4.Family history of hypertension: Hypertension is affected by genetic factors.The proportion of family history of hypertension is the largest in the middle-aged and young hypertension group.5.Types of work: Hypertensive patients at different ages have different types of work.Young and middle-aged hypertensive patients are mainly engaged in mental work.Elderly patients with hypertension are mostly engaged in physical labor-based work,which is characterized by high work intensity during physical labor,intense work at ordinary times,irregular daily life,excessive physical consumption,intense labor nature and great stress in the process of labor,which increases the risk of hypertension.6.Marital status: Marital status is a risk factor for hypertension,and the prevalence rate of stable marriage is higher than that of non-stable marriage.7.Education level: the number of patients with low education level is higher than that of patients with high education level,and the blood pressure control rate is worse than that of those with high education level.The elderly have low education level,low cognitive ability to hypertension,low willingness to acquire health knowledge,low social support,lack of medical insurance,and lack of attention to blood pressure control.Educational factors are of great significance to the prevention and treatment of hypertension.8.Smoking: Smoking is one of the risk factors of cardiovascular disease.Middleaged and young hypertensive patients have bad lifestyle and social communication,more work and entertainment,more work pressure and mental pressure,and frequent smoking,so smokers occupy a dominant position.9.Drinking alcohol: regular drinking will increase the risk of hypertension,and the middle-aged and young hypertension patients who drink alcohol are 1.795 times of those who do not drink alcohol.The middle and young stage is the stage of struggle in life,the study task,work and social intercourse are frequent,the phenomenon of excessive drinking is more frequent than the elderly patients.10.Sleep quality: Sleep quality decreases with age in patients with hypertension.The sleep quality of elderly hypertensive group was worse than that of young and middle-aged hypertensive group.Improving sleep quality and ensuring adequate sleep can assist in lowering blood pressure.11.High-salt diet: the proportion of hypertensive patients with high-salt diet is higher than that of non-high-salt diet.Is an important factor affecting hypertension.12.TCM syndrome type: the TCM syndrome type of the young and middle-aged hypertension group is more likely to develop into irascibility and inflammation syndrome,while the TCM syndrome type of the elderly hypertension group is more likely to develop into kidney qi deficiency syndrome.This distribution difference is related to the pathophysiological changes of the body with age and social work factors.