Study On The Correlation Between The Characteristics Of Cerebral Blood Flow And Yin-Yang Syndrome Differentiation In Patients With Cerebral Microhemorrhage

ObjectiveBy collecting and observing the clinical data of 200 observation subjects,we analyzed the correlation between Cerebral Microbleeds CMBs and hypertension,explored the related risk factors of CMBs,and the correlation between CMBs classification and blood pressure classification and cardiovascular risk stratification.Analyze the characteristics of syndrome differentiation and distribution of Yin-deficiency and Yang-deficiency in CMBs patients,and demonstrate the correlation between TCM syndrome types and hypertension classification and CMBs lesion grading,to explore the relationship between the three,and provide TCM diagnosis and treatment for CMBs patients Evidence-based evidence is helpful for further clinical research on CMBs,and provides reference for clinical blood pressure control and prevention of cerebral microhemorrhage.MethodsAfter passing the review of the hospital ethics committee,the type Ⅲ design plan-retrospective investigation study:a case-control study method,selected according to the inclusion criteria,will be in the outpatient and inpatient department of Shenzhen Traditional Chinese Medicine Hospital from the end of June 2016 to October 2020 A total of 200 patients were diagnosed with essential hypertension,including 125 males and 75 females.Essential hypertension is diagnosed according to the standards of the "Guidelines for Prevention and Treatment of Hypertension in China(2018 Revised Edition)".All patients underwent brain magnetic resonance examination,including T1WI,T2WI,FLAIR sequence,DWI sequence,and SWI sequence.Among them,97 patients were diagnosed as CMBs by MRI functional imaging technology,the positive rate was 48.5%,103 patients whose CMBs were not found by MRI were regarded as the non-CMBs group.In addition to collecting patient’s name,gender,age,outpatient registration number/hospital number,visit time and other general baseline data,personal history such as smoking,drinking,diabetes,hyperlipidemia,severe arrhythmia,hyperhomocysteinemia.In addition to the previous medical history such as cerebral infarction and cerebral hemorrhage,the key medical history data collected include:1.The medical history data such as symptoms and signs,tongue and pulse conditions obtained through the fourth diagnosis of traditional Chinese medicine are used to distinguish yang deficiency and yin deficiency and wind syndrome types.2.Record the blood pressure values measured before the MR examination of the patients,and classify them according to the diagnostic criteria;3.Collect the imaging data of the CMBs patients,and classify the cerebral microhemorrhage according to the diagnostic criteria.After collecting the data in full,enter the statistical software SPSS25.0 for statistical analysis,compare the differences in general baseline data and risk factors between the CMBs group and the non-CMBs group,analyze the correlation between CMBs and hypertension,explore CMBs related risk factors,and CMBs classification and blood pressure.The classification,the correlation of cardiovascular risk stratification,etc.,put the categorical variables into the binary regression equation model to gradually eliminate backwards,and finally obtain the binary Logistic regression equation and corresponding statistics of CMBs.Explore the correlation between essential hypertension,CMBs and TCM syndrome types.Results1.The CMBs group and the non-CMBs group had no significant difference in age,gender,smoking history,drinking history,diabetes history,hyperlipidemia history,severe arrhythmia history,and tumor history composition ratio(P>0.05),while the two groups of brain.There were significant differences in the composition ratio of the history of infarction,the history of cerebral hemorrhage,and the history of cerebral hemangioma(P<0.05).2.1n terms of the correlation between CMBs lesion grading and hypertension classification and risk stratification,CMBs lesion grading of hypertensive patients is positively correlated with the patient’s blood pressure classification(r=0.225,P=0.027,P<α=0.05);the higher the classification level of hypertension,the higher the incidence of CMB,the greater the number of CMB lesions,the higher the classification of CMBs,and the more the lesions appear in the deep part of the brain that are more susceptible to hypertension(P=0.000<0.01);patients with hypertension There was no significant correlation between cardiovascular risk level stratification and CMBs focus classification(r=-0.043,P=0.673,P>α=0.05).3.Most patients with essential hypertension and CMBs have Yang-deficiency and wind-generating syndrome.Compared with the Yin-deficiency and wind-generating group,there are significant differences in the classification of hypertension and the composition ratio of CMBs focus in the Yang-deficiency and wind-generating group(P<0.05);Compared with the level 4 of CMBs,the probability of the dependent variable from 0 to 1 increases for each level of CMBs 1,2,and 3.4.In this study,compared with grade 3 hypertension,the probability of the dependent variable from 0 to I increased by 0.279 and 0.429 times(OR=0.279、0.429,95%CI=0.112～0.699、0.210～0.878)for each increase of grade 1 and 2 of hypertension.OR=0.112～0.699,0.210～0.878),that is,the higher the level of hypertension,the higher the probability of developing CMBs;the probability of developing CMBs in people without a history of cerebral infarction is 0.074 times that of those with a history of cerebral infarction(OR=0.074,95%CI=0.018～0.305);people without a history of cerebral hemorrhage are 0.315 times more likely to develop CMBs than those with a history of cerebral hemorrhage(OR=0.315,95%CI=0.135～0.736);classification of hypertension,history of cerebral infarction and history of cerebral hemorrhage are independent risk factors for the occurrence of CMBs.Conclusion1.Compared with the non-CMBs group,the classification of hypertension and the cardiovascular risk level of hypertension in the CMBs group are generally higher than those in the non-CMBs group.The classification of CMBs in hypertensive patients is positively correlated with the classification of hypertension.The higher the classification of hypertension,the higher the grade of CMBs lesions.2.The classification of hypertension,the history of cerebral infarction and the history of cerebral hemorrhage are independent risk factors for primary hypertension with CMBs.The higher the level of hypertension,the history of cerebral infarction and the history of cerebral hemorrhage in patients with primary hypertension are more likely to develop CMBs.3.In the CMBs group,the main types of TCM syndromes were Yang-deficiency and wind-generating syndromes,accounting for 77.17%,while the non-CMBs group was mainly of Yin-deficiency-generating wind syndromes,accounting for 53.49%.It suggests that CMBs is different from traditional cerebral hemorrhage,which is mainly caused by yin deficiency and yang hyperactivity,and the main pathogenesis is yang deficiency.4.Compared with patients in the yin deficiency and wind generation group,the yang deficiency and wind generation group has a higher classification of hypertension and a higher classification of CMBs lesions.