Correlation Between Different Syndromes Of Traditional Chinese Medicine And The Left Ventricular Structure, Diastolic Functional In Patients With Essential Hypertension

Objective:To study the correlation between different syndromes of Traditional Chinese Medicine and the left ventricular structure,diastolic functional in patients with essential hypertension.METHODS:①100 primary essential hypertension patients(52 males and 48 females)and 20 healthy physical examinees(9 males and 11 females,control group) in Ningde Hospital of Fujian Province were selected from January 2008 to January 2009.According to the standards for the differentiation of syndrome about the clinical research instructive principles in the treatment of hypertension defined in the Principle of Clinical Research for New Traditional Herbs set by the Ministry of Health in 2002,the patients were divided into 4 groups:flaring up of liver fire group(n=36),yin deficiency yang hyperactivity group(n=22),excessive accumulation of dampness phlegm syndrome group(n=26)and yin yang concurrent deficiency group(n=16).②The color Doppler ultrasonography was used to detect the indexes of left ventricular structure:left ventricular end-diastolic diameter(LVDd),interventricular septum thickness,left ventricular posterior wall thickness(LVPWT),and calculate left ventricular mass(LVM)=0.8×1.04×[(LVDd+IVST+PWT)~3-LVDd~3]+0.6g,left ventricular mass index(LVMI)=left ventricular mass/body surface area;indexes of left ventricular diastolic function:left ventricular diastolic peak flow rates at early period(E),left ventricular diastolic peak flow rates at late period(A),mitral valve annular early diastolic tissue Doppler velocity, the time interval during diastole(a) and the duration of the systole S-wave(b),and calculate ratio of transmitral Doppler flow peak early diastolic velocity to peak late diastolic velocities (E/A),ratio of transmitral Doppler flow early diastolic velocityto mitral valve annular early diastolic tissue Doppler velocity(E/Ea),Tei index=(a-b)/b.RESULTS:All the 100 patients with primary essential hypertension and 20 healthy subjects entered the analysis of results.We found that:①Comparison of indexes of left ventricular structure:All the indexes of left ventricular structure in the essential hypertensive patients of different TCM syndromes were significantly higher than those in the control group(P＜0.05).The indexes of LVPWT and LVMI in the flaring up of liver fire group were significantly lower than those in the yin deficiency yang hyperactivity group(P＜0.05).The indexes of LVPWT in excessive accumulation of dampness phlegm syndrome group was significantly lower than those in the yin deficiency yang hyperactivity group(P＜0.05),Most indexes of left ventricular structure in the flaring up of liver fire group and excessive accumulation of dampness phlegm syndrome group were significantly lower than those in the yin yang concurrent deficiency group(P＜0.05).The indexes of LVEDD and LVMI in the yin deficiency yang hyperactivity group were significantly lower than those in the yin yang concurrent deficiency group(P＜0.05).②Comparison of indexes of left ventricular diastolic function:The indexe of E/A ratio in the essential hypertensive patients of different TCM syndromes was signifantly lower than that in the control group(P＜0.05),and the indexes of E/Ea and Tei indax in the hypertensive patients of different TCM syndromes were signifantly higher than those in the control group(P＜0.05).The indexes of E/Ea ratio and Tei index in the flaring up of liver fire group and excessive accumulation of dampness phlegm syndrome group were significantly higher than those in the yin deficiency yang hyperactivity group(P＜0.05).The indexe of E/A ratio in the yin yang concurrent deficiency group was signifantly lower than that in the flaring up of liver fire group(P＜0.05),and the indexes of E/Ea and Tei indax in the yin yang concurrent deficiency group were signifantly higher than those in the flaring up of liver fire group(P＜0.01).The indexes of E/Ea and Tei indax in the excessive accumulation of dampness phlegm syndrome group were signifantly higher than those in the yin yang concurrent deficiency group(P＜0.01).The indexe Tei index in the yin deficiency yang hyperactivity group were significantly higher than that in the yin yang concurrent deficiency group(P＜0.05).CONCLUSION:All the patients with essential hypertension of different TCM syndromes had left ventricular reconstitution of different degree and manifestations of decline of diastolic function in ultrasonic cardiogram,which were more obvious in the hypertensive patients with yin yang concurrent deficiency.