Study On The Differences Of Fundus Changes In TCM Syndrome Types Of Hypertensio

Objective: To analyse the fundus signs of patients with hypertension of different TCM syndrome types,this paper relates different TCM Syndrome Types and fundus changes,and discusses the fundus differences of hypertension of different TCM syndrome types.The combination of local syndrome differentiation and overall syndrome differentiation can provide reference for clinical syndrome differentiation and provide new ideas for the development of modern visual diagnosis of traditional Chinese medicine.Methods: Objective to study the patients with hypertension who were hospitalized in the First Affiliated Hospital of Hunan University of traditional Chinese medicine from September 2018 to January 2021.A total of 363 patients with complete clinical data,laboratory indicators and fundus photography were included,including 172 males and 191 females.According to the guiding principles for clinical research of new Chinese medicine,TCM syndrome types of patients were established:hyperactivity of liver fire(ghks group),hyperactivity of yin deficiency and Yang(yxyk group),hyperactivity of phlegm dampness(tsys group)and deficiency of both yin and Yang(yylx group).The improved u-net network was used to preprocess the fundus images and segment the blood vessels.The curvature of retinal vessels was calculated by the kappa plug-in of Image J software.The angle between the branches of arteries and veins was measured by the angle tool plug-in.The diameter of retinal arteries and veins was measured by the semi-automatic retinal microvascular measurement software vampire(vascular assessment and measurement platform for images of the rtina).Objective to compare and analyze the differences of retinal microvascular morphological indexes in patients with hypertension of different TCM syndromes.Results:(1)According to the symptoms,127 cases(34.9%)were phlegm dampness syndrome,84 cases(23.1%)were liver fire hyperactivity syndrome,79 cases(21.9%)were Yin Yang deficiency syndrome and 73 cases(20.1%)were Yin deficiency yang hyperactivity syndrome.(2)According to Keith wagnar Barker classification,the grade of retinopathy in patients with hyperactivity of liver fire syndrome is mainly grade III,and the degree of retinopathy is more serious,while the grade of phlegm dampness syndrome and Yin Yang deficiency syndrome are mainly grade II-III,while the grade of yin deficiency and yang hyperactivity group is mainly grade I.(3)Retinal vessel diameter: there were differences in superior temporal vein and superior temporal artery among the groups,and the group with excessive phlegm dampness in superior temporal vein was significantly smaller than the other three groups(P < 0.05),while there was no significant difference among the three groups(P > 0.05).The thickness of liver fire hyperactivity group of superior temporal artery was thicker than that of phlegm dampness hyperactivity group(P < 0.05),and thicker than that of yin deficiency and yang hyperactivity group(P < 0.05),but there was no significant difference with Yin-Yang deficiency group(P > 0.05),while there was no significant difference among Yin deficiency and yang hyperactivity group,phlegm dampness hyperactivity group and yin-yang deficiency group(P > 0.05).There was no significant difference between the two groups(P > 0.05).(4)The angle of retinal vascular branches: only the angle of superior temporal vein was different among different syndrome types(P ≤ 0.05),but there was no significant difference among other retinal vascular groups(P > 0.05).The branch angle of superior temporal vein in the phlegm dampness stagnation group was significantly less than that in the liver fire hyperactivity group and yin deficiency yang hyperactivity syndrome,the difference was statistically significant(P < 0.05),and there was no statistical significance between the other groups(P > 0.05).(5)Mean curvature of retinal vessels: there was no significant difference in the curvature of veins among different syndromes(P > 0.05),but there was significant difference in the curvature of retinal arteries(P < 0.05).According to the mean curvature of blood vessels,the hyperactivity of liver fire group > phlegm dampness group > Yin deficiency and yang hyperactivity group / Yin Yang deficiency group.There were significant differences in each artery between hyperactivity of liver fire group and yin deficiency and yang hyperactivity group / Yin Yang deficiency group(P< 0.05),but there was little difference between hyperactivity of liver fire group and phlegm dampness group(P > 0.05).In addition,the mean curvature of the superior temporal artery in the phlegm dampness excess group was larger than that in the yin deficiency and yang hyperactivity group(P < 0.05),and the mean curvature of the inferior temporal artery in the Yin Yang deficiency group was larger than that in the yin yang hyperactivity group(P < 0.05).There was no significant difference between the other groups(P > 0.05).Conclusion:(1)The distribution of TCM syndrome types of hypertension in Hunan Province is mainly phlegm dampness accumulation syndrome,and there is no significant difference in gender of each syndrome type.(2)Different TCM Syndromes of hypertension have different severity of hypertensive retinopathy,which suggests that TCM Syndromes of hypertension can be used to predict the degree of retinal vascular disease,and then predict the degree of target organ damage.(3)Different TCM syndrome types of hypertension patients,retinal vascular morphology differences,to a certain extent,reflect the rationality of TCM syndrome differentiation of hypertension,provide fundus signs as the basis of TCM syndrome differentiation.