Distribution Of Hypertensive Syndrome Elements Of TCM And Correlation With Vascular Aging

1 ObjectivesTo analyze the distribution characteristics of TCM syndrome factors of hypertension;to investigate the effect of hypertension on aging vessel,and to observe the correlation between TCM syndrome factors of hypertension and experimental index of aging vessel.2 MethodsThis clinical trial is a cross-sectional study with a control group. In China Academy of Chinese Medical Science XiYuan Hospital, from 2010～4 to 2011～5we enrolled 111 patients with hypertension qualified and 24 normal adults to divide into two groups, one is adults group (age 40～59), the other is elderlies group (age 60～79), and then according to the clinical classification of hypertension (Grade 1,2,3), we divided patients with hypertension into three sub-groups. Through analyzing the frequency of general information about 135 enrolled patients, we investigated the distribution characteristic of TCM syndrome factors in hypertension patients. To investigate the experimental indexes of aging vessel in subjects, such as information from four TCM diagnostic Methods, pressure, pulse wave velocity (PWV), ambulatory arterial stiffness index (AASI), and plasma Hcy, we analyzed the correlation between these indexes and the TCM syndrome factors of hypertension by multivariate statistics, and investigate the effect of hypertension on aging vessel.3 Results3.17 common factors were obtained by factor analysis.To find out common factors, we have done factor analysis of 36 symptoms and body signs. Characteristic root of common factors enrolled as criteria is more than 1.so we got 7 common factors.7 common factors standing for 7 variables (symptoms) is F1, F2, F3, F4, F5, F6, F7. According to TCM theory, diagnosis criteria of TCM symptom factors and clinical experience, we think that F1 belong to blood stasis, F2 belong to yang deficiency, F3 belong to turbid phlegm, F4 belong to hyperactivity of yang, F5 belong to qi deficiency, F6 belong to blood deficiency, F7 belong to yin deficiency.3.2 Distribution characteristics of TCM symptom factors of hypertension3.2.1 Distribution characteristics of TCM symptom factors of 111 hypertensive patientsThe frequency and rate of 7 common factors in 111 patients with hypertension is: blood stasis 51(45.95%)>qi deficiency 48(43.24%)>yin deficiency 36(32.43%)> hyperactivity of yang 31(27.93%)>turbid phlegm 29(26.13%)>yang deficiency 28(25.23%)>blood deficiency 12(10.81%), it indicates the major symptom factors of 111 patients with hypertension are blood stasis, qi deficiency and yin deficiency.3.2.2 Distribution characteristic of TCM symptom factors in different grades of patients with hypertensionIn 18 patients with grade 1 hypertension, the rate of blood stasis is 66.67%, qi deficiency is 61.11%, they are larger than the others.In 38 patients with grade 2 hypertension, the rate of blood stasis is 44.74%, qi deficiency is 39.48%, yang deficiency is 36.84%, they are larger than the others.In 55 patients with grade 3 hypertension, the rate of blood stasis, qi deficiency and yin deficiency are the same, it is 40.00%, they are larger than the others.3.2.3 Distribution characteristic of TCM symptom factors of patients with hypertension in different age groupsIn 42 patients with hypertension aged 40-59, the rate of blood stasis is the most, it is 50%(21 subjects), hyperactivity of yang and yin deficiency are more, they are respectively 15 and 14 subjects.In 69 patients with hypertension aged above 60, the rate of qi deficiency is the most, it is 53.62%(37 subjects), the second is blood stasis with 43.48%(30 subjects).3.3 Study on the correlation of aging vessel and TCM symptom factors of hypertensionBy Spearman correlated analysis, the plasma Hcy rose remarkably in 111 hypertensive patients with blood stasis; the subjects with qi deficiency had high AGEs, PWV, pulse pressure and AASI, AGEs especially rose remarkably; the subjects with yin deficiency had high AGEs, PWV, pulse pressure and AASI, pulse especially rose remarkably;3.4 Study the relationship between hypertension and the vessel aging3.4.1 Research about the effect of hypertension on promoting the vessel agedAbout the experimental indexes of normal and hypertension subjects, we have done normality test, pulse pressure, AASI, PI, RI and AGEs show normal distribution, and then we do the independent samples T-TEST, there are significant difference on pulse pressure and AGEs between hypertension and control group (P<0.05), it indicates the vessel of hypertension is more aging than the normal subjects in the same age group.PWV, ABI and plasma Hey do not show normal distribution, so we do Mann-Whitney Test, there are significant difference on PWV between hypertension and control group (P<0.05), it indicates the vessel of hypertension is more aging than the normal subjects in the same age group. There are not significant differences on ABI and Hey between hypertension and control group.3.4.2 The correlation between different grade of hypertension and vessel aging in the same age groupAGEs levels of patients with 2 or 3 hypertension was significantly higher (P<0.05) compared with the control group,; and pulse pressure, carotid artery pulsatility index, blood pressure of control group and the patients with 3 grade hepertension are significant differences between groups (P<0.05), suggest vascular aging will be gradually exposed when the patients with hypertention develop to 2 grade hypertension,will be obviously exposed when the patients with hypertention develop to 3 grade hypertension.4 Conclusions4.1 Blood stasis, qi deficiency and yin deficiency are the major symptom factors in 111 hypertensive patients.4.2 Hyperactivity of yang and blood stasis are more in patients with hypertension aged 40-59, qi deficiency and blood stasis are more in patients with hypertensionaged above 60;4.3 The plasma Hey rose remarkably in 111 hypertension with blood stasis;the subjects with qi deficiency had high AGEs, PWV, pulse pressure and AASI, especially AGEs;the subjects with yin deficiency had high AGEs, PWV, pulse pressure and AASI, especially pulse pressure;4.4 The vessel aging of patients with hypertension is more serious than the normal subjects in the same age group.4.5 Following the hypertension get more seriously, the degree of vessel aging in patients with hypertension is enhanced.