| Objective:To explore the distribution characteristics of disease location,disease nature and syndrome type of EH patients by observing the distribution of TCM syndrome elements and the relationship between TCM syndrome elements and related biological indexes in patients with middle and low risk of EH,so as to provide reference for the prevention and treatment of middle and low risk of EH.Methods:In this study,a total of 180 clinical cases who met the inclusion criteria of EH in the middle and low risk group who were treated in the medical examination center of The Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine from November 2020 to January 2022.By collecting the four diagnostic data of traditional Chinese medicine,general information and resting heart rate,blood lipids,serum uric acid(SUA),homocysteine,body mass index(BMI),fasting plasma glucose(FPG)and other related indexes,and using the TCM health state identification system provided by the TCM Syndrome Research Base of Fujian University of traditional Chinese Medicine to identify the syndrome elements of the patients,and set up a database.Statistical analysis was carried out by using SPSS26.0 software to explore the distribution characteristics of the TCM disease nature,disease location,syndrome type and their correlation with biological indexes in patients with middle and low risk of EH.Results:1.In this study,a total of 180 patients with middle and low risk groups of EH were collected,of which 65.6%(118/189)were males and 34.4%(62/180)were females.The ratio of male to female was 1.9:1.The age of the patient was 24～68 years old,and the age of interquartile range was[51.00(44.00,55.00)]years old.2.In this study,the levels of TC,TG and LDL-C in the middle risk group were higher than those in the low risk group,while the HDL-C in the middle risk group was lower than that in the low risk group(P<0.05).There was no significant difference in resting heart rate,SBP,DBP,BMI,SUA,Hcy and FPG between the middle and low risk groups of EH(P>0.05).According to the frequency statistics,the combined risk factors in the middle and low risk groups of EH,dyslipidemia was the most common,followed by overweight,uric acid abnormality,obesity,and hyperhomocysteinemia,smoking history,family history,fasting plasma glucose abnormality.3.Distribution of syndrome elements:(1)The syndrome elements of disease location were counted according to the frequency,which were liver,spleen,gallbladder,kidney,heart spirit,stomach and heart from high to low.There were statistical differences in the syndrome element scores among the disease locations,and there were 8 groups of syndromes in the heart spirit-kidney,heart spirit-spleen,heart spirit-liver,gallbladder-spleen,gallbladder-liver,stomach-liver,kidney-spleen,and kidney-liver(P<0.05).(2)The syndrome elements of disease nature were counted according to the frequency.From high to low,which were phlegm,dampness,qi stagnation,blood stasis,heat,qi deficiency,yang hyperactivity,yin deficiency,yang deficiency,and blood deficiency.There were statistical differences in the disease nature syndrome element scores among the diseases nature,and there were 14 groups of syndrome elements in the blood deficiency-dampness,blood deficiency-phlegm,yang hyperactivity-qi stagnation,yang hyperactivity-blood stasis,yang hyperactivity-dampness,yang hyperactivity-phlegm,yin deficiency-dampness,yin deficiency-phlegm,heat-dampness,heat-phlegm,qi deficiency-dampness,qi deficiency-phlegm,yang deficiency-phlegm,qi stagnation-dampness,qi stagnation-phlegm,blood stasis-dampness,blood stasis-phlegm(P<0.05).(3)The syndrome element scores of liver,gallbladder,kidney,qi stagnation,qi deficiency and yang deficiency in female patients were higher than those in male patients(P<0.05).The syndrome element scores of dampness and heat in male patients were higher than those in female patients(P<0.05).(4)The syndrome element scores of liver,spleen,phlegm,dampness and blood stasis in the middle risk group of EH were higher than those in the low risk group(P<0.05).4.When the cluster analysis was clustered into 6 categories,it was most in line with clinical characteristics.Among them,yang hyperactivity,heart spirit,yin deficiency and heat were clustered into one category;dampness and stomach cluster together into one category;kidney and yang deficiency cluster into one category;phlegm and gallbladder cluster into one category;qi deficiency and blood deficiency cluster into one category;spleen,heart,liver,blood stasis,and qi stagnation cluster into one category.5.Correlation between syndrome elements and clinical indexes:(1)The risk of phlegm syndrome element,dampness syndrome element,qi stagnation syndrome element and liver syndrome element increased by 86.2%,120.4%,39.9%and 38.6%,respecttively,when BMI increased by 1 kg/m~2in middle and low risk of EH.(2)In the middle and low risk patients of EH,the risk of phlegm syndrome element in men is 0.074 times higher than that in women,and the risk of dampness syndrome element is 0.224 times higher than that in women.(3)When the SUA of middle and low risk patients of EH increased by 1μmol/L,the risk of phlegm syndrome element increased by 0.9%,and the risk of dampness syndrome element increased by 0.7%.(4)When the age of middle and low risk patients of EH increased by 1year,the risk of qi stagnation syndrome element increased by 5.1%,and the risk of liver syndrome element increased by 12.2%.Conclusion:1.Overall distribution law of syndrome elements:the main disease location syndrome elements of middle and low risk EH patients are liver and spleen,and the other common syndrome elements are gallbladder,kidney,heart spirit,stomach and heart.The main disease nature syndrome elements of middle and low risk EH patients are phlegm and dampness,and the other common syndrome elements are qi stagnation,blood stasis,heat,qi deficiency,yang hyperactivity,yin deficiency,yang deficiency and blood deficiency.2.Different gender and risk stratification have a certain influence on the distribution of syndrome elements,which has a certain reference value for clinical individualized syndrome differentiation.3.According to the results of cluster analysis,the patients in the middle and low risk groups of EH can be roughly classified into 10 syndrome types:yin deficiency and yang hyperactivity,heat disturbing the heart spirit,dampness evil invading the stomach,kidney yang deficiency,gallbladder depression and phlegm disturbance,qi and blood deficiency,disharmony of liver and spleen,heart blood stasis,qi stagnation and blood stasis,and liver stagnation and qi stagnation syndrome,which can be used for clinical reference.4.The relationship between physical and chemical indicators and TCM syndrome elements:increased BMI is a possible risk factor for phlegm,dampness,qi stagnation and liver syndrome element;increased female and SUA levels are possible risk factors for phlegm and dampness syndrome element;increased age is a possible risk factor for qi stagnation and liver syndrome element. |
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