Study On The Characteristics Of TCM Syndrome Types Of Hypertension In Old Age

ObjectiveTo explore the elderly hypertension patients’ age, sex, blood lipid, blood sugar, heart structure change, the psychological status in different TCM syndrome type distribution. To combine traditional Chinese and western medicine diagnosis and treatment of high blood pressure, especially the modern medical test auxiliary provide reference for TCM syndrome differentiation.MethodsThis study is a cross-sectional survey, cases of sources from the cardiovascular internal ward of People’s Hospital of Fujian Province between 2015.1 and 2015.12, a total of 204 patients with outpatient and inpatient. By incorporating patients with high blood pressure group that conforms to the demands, on the basis of differentiating TCM syndrome in strictly, record their basic clinical data,including blood lipid, blood sugar, cardiac uhrasonography and so on, at the same time to the questionnaire to assess the psychological condition. Through the analysis of variance and nonparametric test to compare distribution of above-mentioned indexes between different hypertension TCM syndrome types.Results1.Constituent ratio:in 204 patients, male 100 cases, female 104 cases. According to syndrome differentiation of TCM diagnostic criteria, five card type structure from high to low is phlegm dampness (25%)> static blood blocking collaterals (22.1%)> hyperactivity of yang due to yin deficiency (20.6%)> deficiency of both yin and yang (18.1%)> overabundant liver fire (14.2%).2. General data analysis:age and course of disease from high to low is deficiency of both yin and yang> hyperactivity of yang due to yin deficiency> static blood blocking collaterals> phlegm dampness> overabundant liver fire; No difference in gender in each syndrome; The most concomitant disease is cerebrovascular disease; The rate of smoking patients and coronary heart disease with phlegm dampness group was obviously higher than that of the other groups.3. TG and TC with highest overabundant liver fire group aged and phlegm dampness group; HDL-C phlegm dampness group is lowest? the rest of the group no significant difference; LDL-C with highest phlegm dampness group and static blood blocking collaterals group, the rest of the group of difference is not obvious.4. FPG with highest deficiency of both yin and yang group and hyperactivity of yang due to yin deficiency group, and getting minimum overabundant liver fire group; HbA1c three highest group are deficiency of both yin and yang. hyperactivity of yang due to yin deficiency, static blood blocking collaterals, phlegm dampness group value close to normal.5. Cardiac structural changes, The overabundant liver fire group LVDd, FVS and LVPW are minimal.; LVDd in deficiency of both yin and yang group and hyperactivity of yang due to yin deficiency group is the largest, and IVS and LVPW in phlegm dampness group is the largest; IVS generally greater than the LVPW.6.Psychological conditions, SSS survey the highest positive rate of deficiency of both yin and yang group, static blood blocking collaterals group and hyperactivity of yang due to yin deficienc group; GAD-7 survey the highest positive rate of deficiency of hyperactivity of yang due to yin deficienc group and overabundant liver fire group. The following is static blood blocking collaterals group. PHQ-7 survey the highest positive rate of deficiency of deficiency of both yin and yang group, there are no differences between the rest of groups.7.The highest 24h average SBP is deficiency of both yin and yang group and hyperactivity of yang due to yin deficiency group, the lowest is phlegm dampness group,24 h average DBP in contrast.Conclusion:1. The elderly hypertensive patients of deficiency of both yin and yang type and hyperactivity of yang due to yin deficiency type are higher than overall hypertension crowd, but phlegmy wet type indicates sheng is still the main form.2. Old age hypertension from age and course of the disease, deficiency of both yin and yang type> hyperactivity of yang due to yin deficiency type> static blood blocking collaterals type> phlegm dampness type> overabundant liver fire type. And in elderly patients with hypertension course of more than 5 years, give priority to with level 3 high blood pressure.3. The most elderly hypertension with cerebrovascular disease general, merge kidney injury at least; phlegm dampness type merge coronary heart disease the most; Smoking as an independent risk factor for hypertension, mainly concentrated in the phlegm wet indicates type.4. TC, TG in overabundant liver fire type are higher than other type; and phlegm dampness type the level of HDL-C decreased significantly, and TG, LDL-C increased obviously, the above can be used as the two syndrome differentiation factors.5. Blood sugar level of deficiency of both yin and yang type and hyperactivity of yang due to yin deficiency type are highest, blood sugar of all kind of syndrome were rising trend.6. LVDd in deficiency of both yin and yang type type to expand the most obvious, and IVS and LVPW expand with phlegm dampness type is most obvious.7. somatization symptoms of deficiency of both yin and yang type is the most serious, followed by static blood blocking collaterals type; More prone to anxiety is overabundant liver fire type and hyperactivity of yang due to yin deficiency type; More prone to anxiety is deficiency of both yin and yang type; and overall anxiety, depression, the overall rate of hypertension of old age patients were higher than in hypertension population as a whole.8. In elderly patients with hypertension, hyperactivity of yang due to yin deficiency type and deficiency of both yin and yang type is given priority to with elevated systolic blood pressure, overabundant liver fire type is given priority to with diastolic blood pressure, for both clinical hypertension syndrome types of antihypertensive treatment should be different.