| ObjectiveBy collecting general data,clinical symptoms,physical and chemical indexes and echocardiographic results of clinical patients,this study observed the distribution characteristic of TCM syndrome types in patients with hypertension combined with hyperuricemia,and explored the effects of hyperuricemia and different TCM syndrome types on physical and chemical indexes,cardiac structure and function of patients with hypertension.To provide some ideas for syndrome differentiation and treatment in TCM of patients with hypertension combined with hyperuricemia,and also for the occurrence and development of related cardiovascular diseases of this disease.MethodsA total of 170 patients with simple primary hypertension(non-HUA group)and 134 patients with hypertension combined with hyperuricemia(HUA group)who were hospitalized in the general and cardiology department of Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University from January 2020 to December 2022 and met the inclusion and exclusion criteria were collected.Collected the general data,clinical symptoms,physical and chemical indexes,and echocardiographic results of patients,whose TCM syndrome differentiation was classified.The data of physical and chemical indexes,cardiac structure and function indexes between the two groups and different TCM syndrome types were statistically analyzed.Results1.Comparison between HUA group and non-Hua group:① The comparison of general data:the population proportion of male,smoking,drinking,pre-existing cerebrovascular disease and very-high-risk hypertension in the HUA group was higher than that in the non-HUA group(P<0.05).The average age and the population proportion of the classified as high-risk hypertension in the HUA group were lower than those in the non-HUA group(P<0.05).② The distribution of TCM syndrome types:the distribution of TCM syndrome types in the HUA group:phlegm-dampness syndrome(39.6%)>overabundant liver-fire syndrome(22.4%)>Yin-Yang deficiency syndrome(20.9%)>Yin deficiency and Yang excess syndrome(17.2%).The distribution of TCM syndrome types in the non-HUA group:Yin-Yang deficiency syndrome(28.2%)>Yin deficiency and Yang excess syndrome(24.7%)>phlegm-dampness syndrome(24.1%)>overabundant liver-fire syndrome(22.9%).The difference in TCM syndrome types between the two groups was statistically significant(P<0.05),and the main reason was that the population proportion of the HUA group was higher than that in the non-HUA group of phlegm-dampness syndrome(P<0.05).③ The comparison of physical and chemical indexes:the levels of TC,TG,LDL-C,BUN,Scr,BNP and HCY in the HUA group were higher than those in the non-HUA group(P<0.05).The level of HDL-C in the HUA group was lower than that in the non-HUA group(P<0.05).However,there was no difference in the level of HbAlc between the two groups(P>0.05).④The comparison of echocardiographic results:the levels of LAD,LVEDd,LVPWT and IVST in the HUA group were higher than those in the non-HUA group(P<0.05).The level of E/A in the HUA group was lower than that in the non-HUA group(P<0.05).However,there was no difference in the level of LVEF between the two groups(P>0.05).2.The comparison of different TCM syndrome types combined with HUA:① Overabundant liver-fire syndrome:the population proportion of hyperlipidemia in the HUA group was higher than that in the non-HUA group(P<0.05).The levels of TG,BUN,Scr,BNP and HCY in the HUA group were higher than those in the non-HUA group(P<0.05).The level of HDL-C in the HUA group was lower than that in the non-HUA group(P<0.05).However,there was no difference in the echocardiographic results between the two groups(P>0.05).② Yin deficiency and Yang excess syndrome:the population proportion of male,coronary heart disease,hypertension grade 3 and very-high-risk hypertension in the HUA group was higher than that in the non-HUA group(P<0.05).The levels of TG,BUN,Scr,BNP and HCY in the HUA group were higher than those in the non-HUA group(P<0.05).The levels of LAD,LVEDd,LVPWT and IVST in the HUA group were higher than those in the non-HUA group(P<0.05).The levels of Ve and E/A in the HUA group were lower than those in the non-HUA group(P<0.05).③ Phlegm-dampness syndrome:the population proportion of male and drinking in the HUA group was higher than that in the non-HUA group(P<0.05).The levels of Scr,BNP and HCY in the HUA group were higher than those in the non-HUA group(P<0.05).The levels of LAD,LVEDd and IVST in the HUA group were higher than those in the non-HUA group(P<0.05).The levels of Ve and E/A in the HUA group were lower than those in the non-HUA group(P<0.05).④ Yin-Yang deficiency syndrome:the population proportion of smoking,drinking,diabetes,hyperlipidemia,pre-existing cerebrovascular disease and very-high-risk hypertension in the HUA group was higher than that in the non-HUA group(P<0.05).The levels of TC,LDL-C,BUN,BNP and HCY in the HUA group were higher than those in the non-HUA group(P<0.05).The level of HDL-C in the HUA group was lower than that in the non-HUA group(P<0.05).The levels of LAD and Va in the HUA group were higher than those in the non-HUA group(P<0.05).3.The comparison of different TCM syndrome types in the HUA group:① The comparison of general data:there were differences in age,hyperlipidemia,and pre-existing cerebrovascular disease among different syndrome types(P<0.05).In terms of age,the age of Yin deficiency and Yang excess syndrome and Yin-Yang deficiency syndrome was higher than that of overabundant liver-fire syndrome and phlegm-dampness syndrome(P<0.05).In terms of hyperlipidemia,the population proportion of hyperlipidemia in overabundant liver-fire syndrome was higher than that in Yin deficiency and Yang excess syndrome(P<0.05).In terms of pre-existing cerebrovascular disease,the population proportion of pre-existing cerebrovascular disease in Yin-Yang deficiency syndrome was higher than that in Yin deficiency and Yang excess syndrome and phlegm-dampness syndrome(P<0.05).② The comparison of physical and chemical indexes:there were differences in the levels of TG and BNP among different syndrome types(P<0.05).The level of TG in phlegm-dampness syndrome was higher than that in Yin-Yang deficiency syndrome(P<0.05).The level of BNP in Yin deficiency and Yang excess syndrome and Yin-Yang deficiency syndrome was higher than that in phlegm-dampness syndrome(P<0.05).③ The comparison of echocardiographic results:there were differences in the levels of LVEDd among different syndrome types(P<0.05).The level of LVEDd in overabundant liver-fire syndrome and phlegm-dampness syndrome was higher than that in Yin-Yang deficiency syndrome(P<0.05).ConclusionsThe study confirmed that the distribution characteristic of TCM syndrome types in patients with hypertension is related to hyperuricemia.In patients with simple hypertension,Yin-Yang deficiency syndrome was the main syndrome,while in patients with hypertension combined with hyperuricemia,phlegm-dampness syndrome was the main syndrome.The study preliminarily verified the correlation between hyperuricemia and the physical and chemical indexes,cardiac structure and function indexes of hypertension patients.And the study was found that the levels of TG,BNP and LVEDd were different in different TCM syndrome types of hypertension combined with hyperuricemia.The results above provide certain basis of objective laboratory indexes for TCM syndrome differentiation,and also provide certain reference indexes for the occurrence and development of diseases of different syndrome types. |
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