| Objective To evaluate the correlation between Syndrome differentiation in traditional Chinese medicine and vascular remodeling and blood pressure variability in hypertensive.Carotid arteries were determined by ultrasonic examination,and the ambulatory blood pressure were monitored in hypertensive in different types of syndrome in this study.We wanted to provide a relatively objective and normative standards for Syndrome differentiation in traditional Chinese medicine with a view of using the information obtained by the ultrasound data and the objective ambulatory blood pressure variability. Methods Totally 160 out-patients or in-patients(84 males and 76 female, the oldest was 87 years old and the youngest was 22 years old,average age was 62.0 years old.) with hypertension in affiliated hospital of Guangzhou University of Traditional Chinese Medicine in Shenzhen between October 2007 and March 2009 were voluntarily involved in the study,all of whom were in line with the 2005 "guide to prevention and treatment of hypertension in China" diagnostic criteria for hypertension.According to the standards for the differentiation of syndrome about the clinical research in the Principle of Clinical Research for New Traditional Herbs,the patients were divided into 4 types:liver-fire hyperactivity,excessive accumulation of phlegm-dampness, hyperactivity of yang due to yin deficiency,deficiency of both yin and yang. The patients were studied by Agilent sonos 5500 Color Doppler ultrasound (transducer frequency of 7-11MHz) of the United States Agilent Corporation. The measurements were as follows:IMT(Intima-media thicking),plaque,blood flow velocity,RI(resistance index) of carotid artery,observed and compared carotid artery vascular remodeling in different types of syndrome.At the same time,monitoring 24-hour ambulatory blood pressure of patients,the normal standards of ambulatory blood pressure reference to domestic recommendation[50], in which 24h mean blood pressure values＜130/80 mmHg,daytime mean＜135/85mmHg, night＜125/75mmHg,and the mean blood pressure of night-time lower＞10%than that of daytime.Blood pressure monitoring including the average 24h systolic blood pressure(SBP),average diastolic blood pressure(DBP),and the average pressure(MBP).These measurement s and the age,course of disease of the patients were analyzed with spss10.0 statistical package.Results IMT and plaque detection rate were higher in excessive accumulation of phlegm-dampness group than other groups(P＜0.01 or P＜0.05).The blood flow velocity of LCCA in liver-fire hyperactivity and excessive accumulation of phlegm-dampness groups were significantly higher than those in other two groups(P＜0.01).The blood flow velocity of RCCA in liver-fire hyperactivity and excessive accumulation of phlegm-dampness groups were significantly higher than those in other two groups(P＜0.01).RI of the LCCA were higher in excessive accumulation of phlegm-dampness group than other three groups (P＜0.01 or P＜0.05).RI of the RCCA were higher in excessive accumulation of phlegm-dampness group than other groups(P＜0.01).The average systolic and diastolic blood pressure inter-24h in different syndrome types has no significant differences(P＞0.05).Variability of blood pressure in liver-fire hyperactivity and excessive accumulation of phlegm-dampness groups were significantly higher than those in other two groups(P＜0.01 or P＜0.05). Variability of blood pressure in hyperactivity of yang due to yin deficiency group was not significant with deficiency of both yin and yang group(P＞0.05). The age of the patients of the liver-fire hyperactivity group was significantly younger than other three groups(P＜0.01).The course of the disease in excessive accumulation of phlegm-dampness and deficiency of both yin and yang.groups were significantly longer than other two groups(P＜0.01).Conclusion Carotid artery remodeling and Syndrome differentiation in traditional Chinese medicine has a good relationship in hypertension.And the association of carotid artery ultrasonography and ambulatory blood pressure monitoring of these two detection methods had a certain consistency with TCM different syndromes of hypertension,increase in blood pressure variability, carotid blood flow,RI,IMT,plaque to a certain extent had significance to the treatment and sub-type on the TCM.,which could provide objective and quantifiable indicators for TCM clinical treatment of hypertension. |
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