Retrospective Analysis Of The Correlation Between Different TCM Syndrome Types And Cerebrovascular Lesions In Essential Hypertension

ObjectiveBased on the syndrome differentiation and classification of patients with primary hypertension(EH)mainly characterized by dizziness,and combined with the similarities and differences in the cranial magnetic resonance(MRI)results of such patients,the correlation between different traditional Chinese medicine syndrome types of EH and the occurrence of cerebral small vessel disease(CSVD)is analyzed.From the perspective of integrating traditional Chinese and Western medicine,this study aims to provide reference and objective basis for the treatment of EH and the prevention and treatment of cerebrovascular diseases through syndrome differentiation and classification in traditional Chinese medicine.MethodsAccording to the national planning textbook of the "12th Five Year Plan" for regular higher education undergraduate students in the "Internal Medicine of Traditional Chinese Medicine",the four diagnostic data of middle-aged and elderly inpatients who met the EH diagnostic criteria and were diagnosed with "dizziness" from January 2017 to December 2021 at the People’s Hospital affiliated with Fujian University of Traditional Chinese Medicine were classified into five syndrome types: liver yang hyperactivity syndrome,qi and blood deficiency syndrome,phlegm turbidity obstruction syndrome,blood stasis obstruction syndrome,and kidney essence deficiency syndrome,And collect the imaging findings,general situation,and related clinical indicators of small vessel imaging in such patients.By establishing a raw data database and using SPSS 24.0 software to analyze the data,explore the internal relationship between different traditional Chinese medicine syndrome types of primary hypertension and the occurrence of small vessel lesions.result1.In general,from January 2017 to December 2021,a total of 2321 hospitalized patients who met the inclusion and exclusion criteria of this study were treated at the People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine.Among them,there were1149 males(49.5%)and 1172 females(50.5%),with a male to female ratio of 0.98:1.The age range of patients is 45 to 89 years old,and the average age can be expressed as 68.00(57.00,79.00)using median and interquartile spacing methods.The minimum and maximum values of body mass index are 16.5 and 31.3(in kg/m2),respectively.Among them,33 people had a BMI ≤ 18.4,1197 people had a BMI ≤ 18.5,959 people had a BMI ≤ 24.0,and 132 people had a BMI ≤ 28.0.There was no statistical difference in general conditions of patients with different syndrome types,such as gender,age,body mass index,CRP,diabetes,hyperlipidemia,HUA,HHcy,and thickening/plaque of tunica intima in the neck.2.TCM syndromes: According to the proportion from high to low,1039 cases(44.77%)of phlegm obstruction syndrome,795 cases(34.25%)of blood stasis obstruction syndrome,264 cases(11.37%)of qi and blood deficiency syndrome,148 cases(6.38%)of liver yang hyperactivity syndrome,and 75 cases(3.23%)of kidney essence deficiency syndrome were listed in order.The distribution of TCM syndrome types in EH patients with "vertigo" as the main symptom has statistical differences.3.Cerebrovascular lesions: According to the results of brain magnetic resonance imaging of 2321 patients,there were 1985 patients(85.52%)with cerebrovascular lesions,and 336patients(14.48%)without cerebrovascular lesions.Among them,WMH1915(82.51%),PVS1769(76.22%),senile brain changes 1243(53.55%),lacuna 1089(46.92%),CMB596(25.68%),RSSI 356(15.34%).4.The distribution of cerebral small vessel lesions among different TCM syndromes: 26 patients with hyperactivity of liver yang syndrome(17.57%),22 patients with WMH1(82.43%),76 patients with senile brain changes(51.35%),35 patients with RSSI(23.65%),54 patients with CMB(36.49%),107 patients with PVS(72.30%),11 patients without cerebral small vessel lesions(7.43%);Among the patients with deficiency of qi and blood,40(15.15%)had lacunar,22(84.10%)WMH,147(55.68%)senile brain changes,17(6.44%)RSSI,61(23.11%)CMB,95(73.86%)PVS,and 39(14.77%)had no small cerebral vascular lesions;There were 582 patients(56.02%)with lacunae,863 patients(83.06%)with WMH,541patients(52.07%)with senile brain changes,85 patients(8.18%)with RSSI,55 patients(24.54%)with CMB255,805 patients(77.48%)with PVS,153 patients(14.73%)without small cerebral vascular disease;Among the patients with blood stasis obstruction syndrome,427(53.71%)were lacunae,643(80.88%)were WMH,426(53.58%)were senile brain changes,214(26.92%)were RSSI,208(26.16%)were CMB208(26.16%),107(76.35%)were PVS607,and 124(15.60%)were without small cerebral vascular lesions;Among the patients with kidney essence deficiency syndrome,14(18.67%)had lacunae,65(86.67%)had WMH,53(70.67%)had senile brain changes,5(6.67%)had RSSI,18(24%)had CMB18,55(73.33%)had PVS,and 6(8%)had no cerebrovascular disease.Conclusion1.Physical and chemical factors such as sex,age,body mass index,CRP,diabetes,hyperlipidemia,HUA,HHcy,and thickening/plaque of cervical tunica intima are significantly related to the occurrence of CSVD in EH patients,which are risk factors for the occurrence and development of CSVD.2.There are differences in the types of cerebral small vessel lesions in patients with primary hypertension with different traditional Chinese medicine syndrome types,which to some extent reflects the correlation between traditional Chinese medicine syndrome types and cerebral small vessel lesions in primary hypertension.It is suggested that early prevention and treatment can be carried out based on the correlation between traditional Chinese medicine syndrome types and cerebrovascular diseases in patients with primary hypertension,in order to reduce the incidence of cerebrovascular diseases after hypertension.