| Objective:To explore the distribution of TCM syndromes of hypertension and the influencing factors of hypertension complications,so as to provide theoretical support for TCM and western medicine prevention and treatment of hypertension,delay the progression of hypertension and reduce the occurrence of hypertension complications.Methods:In this study,1261 patients with hypertension admitted to the Hospital of Gansu University of Chinese Medicine from January 1,2017 to December 31,2021 were collected by HIS system for retrospective analysis.Count number(form)is used to describe data,uses thex~2test or Fisher’s exact probability method rate comparison,thex~2segmentation method is adopted for hypertension TCM syndrome types in the two comparison on the various complications.When the measurement data met the normal distribution,was used for statistical description,and t test was used for comparison between groups.When the normal distribution was not satisfied,the median(quartile)was used for statistical description,and the non-parametric test was used for comparison between groups.The statistical significance of univariate analysis was included into logistics regression model,and the influencing factors of hypertension complications were analyzed by multi-factor logistics regression.Results:(1)This study collected 1261 medical records of hypertension patients meeting the requirements,male accounted for 42.59%,female accounted for 57.41%.The age of the subjects was mainly over 60 years old,accounting for 77.80%.Family history accounted for22.76%,smoking history accounted for 11.74%,drinking history accounted for 6.58%,the course of hypertension mostly within 20 years accounted for 76.13%,and the classification of hypertension was mainly Grade 3 hypertension,accounting for 86.44%.High blood pressure patients admitted to the peak solar terms in Qingming,Awakening of insects,summer solstice,cold dew,heavy snow;Admission of low solar terms in the Major cold,autumn Equinox.Patients with hypertension were admitted more frequently in spring and summer than in autumn and winter.Phlegm-stasis interjunction syndrome of hypertension patients,accounting for 48.37%.Hypertension combined with one disease accounted for 64.47%,among which T2DM accounted for 17.92%,CVA accounted for 16.34%,CHD accounted for18.95%,HN accounted for 9.75%,CI accounted for 1.51%.(2)There were statistically significant differences in the distribution of TCM syndromes of hypertension in gender,age,season and complications(P<0.05),and there were statistically significant differences between hypertension combined with diabetes mellitus,stroke,coronary heart disease and cardiac insufficiency and hypertension combined with kidney disease(P<0.005).(3)Hypertension combined with T2DM was correlated with blood glucose,TG,HDL,Hcy,FIB and other indexes,and the results were statistically significant(P<0.05).Hypertension combined with CVA was associated with age,disease course,family history,diastolic blood pressure,blood glucose,TG,TC,HDL,Hcy,UA and other indicators,and the results were statistically significant(P<0.05).Hypertension combined with CHD was correlated with gender,age,diastolic blood pressure,heart rate,blood glucose,TG,Cr,FIB and other indexes,and the results were statistically significant(P<0.05).Hypertension combined with HN was correlated with gender,age,smoking history,drinking history,family history,diastolic blood pressure,blood glucose,HDL,LDL,BUN,Cr,UA and other indicators,and the results were statistically significant(P<0.05).Hypertension combined with CI was correlated with age,disease course,TG,BUN,Cr,UA,platelet and other indexes,and the results were statistically significant(P<0.05).(4)Multivariate logistic regression analysis showed that TG,Hcy,FIB may be the risk of hypertension combined with T2DM Risk factors(TG:OR=1.210,95%CI 1.088-1.346;Hcy:OR=1.980,95%CI 1.968-1.992;FIB:OR=1.254,95%CI 1.058-1.487);HDL may be a protective factor for hypertension combined with T2DM(OR=0.612,95%CI 0.409-0.916).Age,course of disease>20 years,family history,blood glucose and Hcy may be the risk factors of hypertension complicated with CVA(60-69 years old:OR=1.168,95%CI1.168-2.655;70-79 years old:OR=1.761,95%CI 1.761-4.036;Over 80 years old:OR=2.243,95%CI 2.243-5.500;Disease duration>20 years:OR=1.411,95%CI 1.023-1.946;Family history:OR=1.678,95%CI 1.492-1.935;Blood glucose:OR=1.922,95%CI 1.875-1.971;Hcy:OR=1.019,95%CI 1.008-1.030).Age,blood glucose and FIB may be risk factors for hypertension complicated with CHD(60-69 years old:OR=2.216,95%CI 1.545-3.180;70-79years old:OR=2.238,95%CI 1.547-3.239;Over 80 years old:OR=2.281,95%CI 1.534-3.391;Blood glucose:OR=1.880,95%CI 1.833-1.930;FIB:OR=1.823,95%CI 1.684-1.991).Gender,family history and Cr may be the risk factors of hypertension combined with HN(female:OR=2.473,95%CI 1.589-3.847;Family history:OR=2.100,95%CI 1.474-2.991;Cr:OR=1.041,95%CI 1.030-1.052);Age may be a protective factor for hypertension combined with HN(60-69 years old:OR=0.339,95%CI 1.589-3.847;70-79 years old:OR=0.262,95%CI 0.163-0.420;Over 80 years old:OR=0.189,95%CI 0.110-0.326).Age,TG and UA may be the risk factors of hypertension complicated with CI(70-79 years old:OR=3.899,95%CI 1.692-8.986;Over 80 years old:OR=5.838,95%CI 2.521-13.517;TG:OR=1.569,95%CI 1.413-1.785;UA:OR=1.005,95%CI 1.003-1.007).Conclusion:(1)The TCM syndrome types of hypertension have certain distribution rules in gender,age,season and complications.The deficiency syndrome of female patients with hypertension is more than that of male patients.With the increase of age,the proportion of deficiency syndrome will increase;In spring,hypertension is mainly caused by Yin deficiency of liver and kidney,hyperthyroidism of liver and Yang and deficiency of kidney qi.In summer,hypertension is mainly caused by combination of phlegm and blood stasis,and obstruction of phlegm and dampness.In winter,hypertension is mainly caused by Yin deficiency and Yang hyperactivity.The proportion of hypertension combined with kidney disease in phlegm and blood stasis,Yin deficiency and Yang hyperactivity is higher than other complications.(2)TG,Hcy and FIB are risk factors for hypertension combined with diabetes.And HDL is a protective factor for hypertension combined with diabetes.Age,disease course>20 years,family history,blood glucose and Hcy are risk factors for hypertension combined with stroke.Age,blood glucose and FIB are risk factors for hypertension combined with coronary heart disease.Gender,family history and Cr are the risk factors of hypertension combined with nephropathy.And age may be a protective factor.Age,TG,and UA are risk factors for hypertension combined with cardiac insufficiency. |
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