The Retrospective Research On Traditional Chinese Medicine Syndromes Of Hypertension With Carotid Atherosclerosis

Objective:This subject is one of the elements of Science and Technology Department of Guangdong Province research topic(2008B060600071). Our previous studies have shown that There are six kinds of clinical TCM syndromes of hypertension with carotid ath-erosclerosis, including Qi-dificiency and phlegm-stasis, qi-dificiency and blood-stasis, qi stagnation induced blood stasis, qi-dificiency and phlegm-stagnancy, yin-deficiency, phlegmy-heat. Documents for this study was recalled by Guangzhou area of research, further clarify TCM syndromes of hypertension with carotid ath-erosclerosis and research the correlation of Traditional Chinese Medicine Syndromes of Hypertension with carotid Atherosclerosis and Liqid, Uric acid, fibrinogen, high sensitive C-reactive protein, blood rheology, to explore TCM syndromes of hypertension with carotid atherosclerosis in South Region and the syndromes of drug use, to provide a basis for standardization of TCM syndromes of hypertension with carotid atherosclerosis. In order to provide a effective Chinese medicine treatment method for complications of hypertension.Methods:553 cases about hypertension with carotid atherosclerosis were selected in the hospital ward of the Second Hospital of Guangdong Province, The 1st affiliated hospital of guangzhou university of Chinese traditional medicine, Guangzhou TCM hospital, from January 2005 to December 2010. Collected each patient about gender, age, course of disease, TCM syndrome type, high blood pressure levels, carotid atherosclerosis, and related lab index about triglycerides(TG), total cholesterol (TC), low density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol (HDL-C), uric acid(UA), fibrinogen(FIB), high sensitive C-reactive protein(hs-CRP), blood rheology and the syndromes of drug use. The results were obtained by using the SPSS17.0 statistical software for data processing. Measurement data as mean ±standard deviation,count data were analyzed by chi-square test, recombination between comparision using analysis of variance. When P≤0.05, the difference has the statistics significant.Results:(1) 553 cases about hypertension with carotid atherosclerosis were selected, including 264 men, agee 36～83 years old, average age (71.11±9.65) years of age, and 289 women, aged 45～89, average age (69.91±10.37) years.(2)Distribution of TCM syndromes:The study found that patiens about hypertension with carotid atherosclerosis in TCM syndrome, qi-dificiency and phlegm stagnation syndrome was the highest among these TCM syndromes(31.83%), followed with qi deficiency and blood stasis(22.87%)and qi-deficiency and phlegm(20.61%), liver-yang hyperactivity(10.67%), yin deficiency of liver and kidney(7.78%), phlegmy-heat syndrome(6.33%).(3)Age distribution:The average age of TCM syndromes comparison were significant differences (P<0.05). After multiple comparisons between groups, we found that phlegmy-heat syndrome in the average of less than qi-dificiency and phlegm stagnation syndrome, qi deficiency and phlegm, qi deficiency and blood stasis, yin deficiency of liver and kidney syndromes, differences were statistically significant, P<0.05. The rest group comparative differences were statistically significant, P>0.05.(4)Course of disease distribution:The course of disease in TCM syndromes comparison were significant differences(P<0.05). After multiple comparisons between groups, we found that qi-dificiency and phlegm stagnation syndrome in the course of disease greater than liver-yang hyperactivity, qi deficiency and phlegm, phlegmy-heat syndromes, differences were statistically significant, P<0.05. The rest group comparative differences were statistically significant, P>0.05.(5)Blood pressure classification:Blood pressure classification in TCM syndromes comparison were significant differences (P<0.01). Qi-dificiency and phlegm stagnation syndrome, qi deficiency and phlegm syndrome, deficiency and blood stasis syndrome with 3 levels of hypertension, account for the 78.99%,71.93%,81.75%. Liver-yang hyperactivity syndrome, phlegmy-heat syndromes and yin deficiency of liver and kidney syndromes with 2 levels of hypertension, accourt for the 49.16%,51.43%,67.44%.(6)Plaques positive comparison:Qi-dificiency and phlegm stagnation syndrome plaques positive rate (88.64%) was significantly higher than that of other syndromes group, differences were statistically significant,P<0.05.(7)Plaque group compared with non-plaque group:Plaques group in the course, TC, LDL-C,uric acid, fibrinogen, high sensitive C-reactive protein, blood rheology were significantly higher than non-plaque group, differences were statistically significant, P<0.05.(8)Comparison of serum lipids:TG, HDL-C in TCM syndromes comparison were not significant differences (P>0.05). Qi deficiency and phlegm group TC and LDL-C level is significantly higher than in the rest of the group, statisticant differences(P<0.05).(9)Comparison of serum uric acid levels:Uric acid in TCM syndromes comparision, qi-dificiency and phlegm stagnation syndrome is significantly higher than in the rest of the group(P<0.05), the differences had the statistics significance.(10)Comparision of Fibrinogen in the blood:Among the various TCM syndromes, after pairwise comparision between groups, we obtained the level of fibrinogen in qi-dificiency and phlegm stagnation syndrome, qi deficiency and phlegm, qi deficiency and blood stasis was significantly higher than liver-yang hyperactivity and phlegmy-heat syndrome(P<0.05), the differences had the statistics significance. The level of fibrinogen in yin deficiency of liver and kidney syndrome was higher than phlegmy-heat syndrome(P<0.05), the differences had the statistics significance. The other groups compared with yin deficiency of liver and kidney syndromes were not significant differences(P>0.05).(11)Comparision of high sensitive C-reactive protein:Among the various TCM syndromes, the level of high sensitive C-reactive protein in qi-dificiency and phlegm stagnation syndrome was significantly higher than the rest of the groups(P<0.05).The level of high sensitive C-reactive protein in liver-yang hyperactivity syndrome was significantly lower than the rest of the groups(P<0.05), the differences had the statistics significance.(12)Comparision of blood rheology:Among the various TCM syndromes, the level of blood rheology in qi-dificiency and phlegm stagnation syndrome was significantly higher than the rest of the groups (P<0.05), the differences had the statistics significance.(13) Recipe of the study we founnd Pinellia ternate, Poria, Baizhu, the codonopsis pilosula, the dried orange peel, the amomum xanthioides, the herbaceous peony, the Chinese angelica, the safflower, Danshen Root and so on appears the frequency is highest.Conclusion:(1)TCM syndrome of hypertension with carotid atherosclerosis distribution rule:qi-dificiency and phlegm stagnation syndrome) qi deficiency and blood stasis>qi deficiency and phlegm>liver-yang hyperactivity> yin deficiency of liver and kidney>phlegmy-heat syndrome, of which the most qi-dificiency and phlegm stagnation syndrome(31.83%), and the syndrome of patients with long, high blood pressure levels, plaque detection high rates(88.64%).(2)Confirmed the extension of disease and blood TC, LDL-C, uric acid, fibrinogen, high sensitive C-reactive protein, elevated levels of blood rheology were the main factors lead to plaque formation.(3) Elevated levels of blood rheology can be used as objective index of qi-dificiency and phlegm stagnation syndrome. TC and LDL-C increased can be used as an objective index of qi deficiency and phlegm. The level of serum uric acid could be used as reference indicators of liver-yang hyperactivity syndromes. High sensitive C-creative protein level can be used as reference indicators of differential interference within phlegmy-heat syndrome.Blood level of fibrinogen can be used as phlegmy-heat syndrome and liver-yang hyperactivity identification indicators.