The Study Of Syndromes Of Traditional Chinese Medical(TCM) And Clinical Characteristics, Risk Factors Of High Altitude Deterioration

Backgroud and objective:High altitude was a hostile environment. Physiological stress from hypoxia, cold, wind,UV rays from the sun, dehydration and a lack of antioxidant nutrients in the diet allcontribute to decrease physical and mental performance at altitude. When people first gotinto high altitude, internal environment homeostasis had been destroyed. Peoples’physiologic function had been disturbed. For adapting the hypoxia environment, peoples’physiologic function had been readjusted. For example, heart rate might be faster,pulmonary ventilation might be increased. Hemoglobin might be increased appropriately.This process which organism had getten homeostasis again had been called acclimatization.Peoples who had remained or lived at high altitude for prolonged periods of time shouldappear a series of symptoms including lethargy, impaired cognitive function, anorexia andweight loss. Milledge JS, West JB had called this syndrome to high altitude deterioration.Chinese scholars had officially named this syndrome as high altitude deterioration in theThird Chinese National Symposium on High Altitude Medicine on September1995. Highaltitude deterioration had been divided into mental deterioration(MD) and physicaldeterioration(PD).For a long time, there were little inhabitants in mountains which locatedin Europe and America, so foreign scholars thought that high altitude deterioration was nota type of chronic mountain sickness. Although Chinese scholars thought high altitudedeterioration should be understand a type of chronic mountain sickness, but there were littleliterature which involved high altitude deterioration. Up to now, pathogenesis and treatmentof high altitude deterioration had remained uncleared. This study aimed to explore thesyndrome differentiated treatment of high altitude deterioration by TCM.Method:There were886Han young men who immigrated to high altitude (3640m to5390m). All of the respondents were born in plain, before they would immigrated to high altitude,they had been confirmed healthy through physical examination. All of the patients andhealthy peoples had been asked to fill out the symptom questionnaires to assess the mainsymptoms of HAPD. They also had been assessed a series of physiological indexs sucha ascognitive function(digit span test, Benton virtual retention), reven test, blood viscosity,hematocrit, red blood cell count, leucocyte count, platelet count, left ventricular systolicfunction, left ventricular ejection function, cardiac function index. We tried to explore theclinical features of high altitude deterioration from these physiological indexs. For explorerisk factors of HADT,we had set a series of factors(sleep quality, depression-dejection,anger-hostile, smoking, tension-anxiety, life-time at high altitude), we tried to explore therisk factors of HADT from these factors. At the same time, we had collected the TraditionalChinese Medicine syndromes to explore the syndrome characteristics of high altitudedeterioration by Traditional Chinese Medicine.Result:1. The prevalence rates of high altitude physical dterioration were30.3%at3640m,33.6%at4516m,35.7%above5000m.2. The prevalence rates of high altitude mental dterioration were35.5%at3640m,42%at4516m,45.6%above5000m.3. The syndromes of high altitude mental dterioration were syndrome of deficiency ofboth heart and spleen, syndrome of disharmony between heart and kidney, deficiency ofkidney yang.4. The syndromes of high altitude physical dterioration were syndrome of deficiency ofspleen-Qi， syndrome of insufficiency of kidney essence, deficiency of lung Qi.5. Fatigue, anorexia, and catching a cold repeatedly were main symptoms of highaltitude physical dterioration. Compare with high altitude healthy peoples, patients’ plateletcount, blood pressure, EF and FS were lower than healthy people, but patients’ bloodviscosity and hemoglobin concentration were higher than healthy people.6. Momery loss and sleep disturbance were main symptoms of high altitude mentaldterioration. Compare with high altitude healthy peoples, patients’ blood viscosity andhemoglobin concentration were higher than healthy people, but platelet count and oxygensaturation were lower than healthy people. 7. Depression-dejection (OR=1.405,95%CI=1.036-1.906)，sleep quality(OR=2.35,95%CI=1.465-3.77) were risk factors for MD.8. Anger-hostile,(OR=1.649,95%CI=1.176-2.313)， sleep quality (OR=1.68795%CI=1.016-2.802) were risk factors for PD.Conclusion:1. The clinical features of high altitude mental deterioration were:1. Patients hadcognitive impairment.;2.Blood was thicker than healthy peoples’ blood;3.Patients with highaltitude mental deterioration were earier bleed than healthy people.2. The clinical features of high altitude physical deterioration were:1.Patients’ capacityfor physical labour had declined;2.Patients’left ventricular systolic functiondeclined;3.Blood was thicker than healthy peoples’ blood;3.Patients with high altitudephysical deterioration were earier bleed than healthy people.3. Analysis from the perspective of Traditional Chinese Medicine, the etiology of theHAMD is hypoxia. It involved spleen、 heart and kidney. The characteristics ofdifferentiation of HAMD was deficiency complicated with blood stasis. The most importantwas deficiency of Qi、blood and essence. However, all of the HAMD patients had bloodstasis. Blood stasis also played an important role in HAMD.4. Analysis from the perspective of Traditional Chinese Medicine, the etiology of theHAPD is hypoxia. It involved spleen、lung and kidney. The characteristics of differentiationof HAPD was deficiency complicated with blood stasis. The most important was deficiencyof Qi、blood and essence. However, all of the HAPD patients had blood stasis. Blood stasisalso played an important role in HAPD.5. Insomnia and depressed mood were related to cause of MD.6. Anger mood were related to cause of PD.