The Correlation Study In The Heart Damage Of Hypertension With Different Syndromes Of Traditional Chinese Medicine By Echocardiography

Objective:To observe the relation of the cardiac structures, left vebtricular diastolic and systolic function, age, course of diseases, syndrome types to hypertention grades and risk stratification in primary hypertention by the method of syndrome differentiation in traditional Chinese medicine combining with achievements in modern medicine. To analyze the different heart damage in different types of syndyome. Methods:Totally 100 outpatients or inpatients (51 males and 49 female) with essential hypertension in the Department of Cardiology ShenZhen traditional Chinese medicine hospital between March 2005 and March 2006 were voluntarily involved in the study. According to the standards for the differentiation of syndrome about the clinical research instructive principles in the treatment of hypertension defined in the Principle of Clinical Rasearch for New Traditional Herbs set by the Ministry of Health, the patients were divided into 4 types:liver-fire hyperactivity, hyperactivity of yang due to yin deficiency, excessive accumulation of phlegm-dampness, deficiency of both yin and yang. The patients were studied by echocardiography. The measurements were as follows:AA, LVPWd, IVsd, LVDd, LAd, mitral valve anterior leaf EF slope, interventricular septal amplitude and left ventricular posterior wall moving amplitude, LV ejection fraction(EF), left ventricular fractional shortening(FS), early filling velocity of the E wave(V_E), peak A wave velocity(V_A), mitral valve peak flow velocity E/A ratio. These measurements and the age, course of diseases, syndrome types to hypertention grades and risk stratification of the patients were analyzed with SPSS10.0 and Epitable statistical software.Results:All 100 patients entered the result analysis,①The abnormal cardiac structures: liver-fire hyperactivity group< hyperactivity of yang due to yin deficiency group< excessive accumulation of phlegm-dampness group< deficiency of both yin and yang group.②The decreased of left ventricular diastolic and systolic function: liver-fire hyperactivity group< hyperactivity of yang due to yin deficiency group< excessive accumulation of phlegm-dampness group< deficiency of both yin and yang group. The left ventricular wall and interventricular septum systolic moving amplitude were significantly increased in hyperactivity of yang due to yin deficiency group than other groups(P＜0.05).③The age of liver-fire hyperactivity group was significantly younger than other groups(P＜0.05).④The course of diseases: liver-fire hyperactivity group < hyperactivity of yang due to yin deficiency group < excessive accumulation of phlegm-dampness group < deficiency of both yin and yang group. The diseases course of patients in excessive accumulation of phlegm-dampness and deficiency of both yin and yang groups were significantly longer than the other two groups(P＜0.05).⑤The difference of blood pressure grades among patients with different syndrome types was not significant(P＞0.05).⑥The risk stratification in liver-fire hyperactivity and hyperactivity of yang due to yin deficiency groups were significantly lower than those in excessive accumulation of phlegm-dampness group(P＜0.05). The difference of the risk stratification in deficiency of both yin and yang group was not significant with other groups.Conclusion: The cardiac structures, left vebtricular diastolic and systolic function can be the objective indicator when diagnose by syndrome differentiation in traditional Chinese medicine. The age, course of diseases, risk stratification in primary hypertention of patients also can be the objective indicator when diagnose by syndrome differentiation in traditional Chinese medicine. And these objective indicators can provide basis for determining therapeutic principle.