Relationship Between Hypertension And Insomnia And The Intervention Of Traditional Chinese Medicine On Hypertension With Insomnia

This paper is divided into two parts:literature review and clinical research.The first part:literature reviewThe literature review discusses the understanding of sleep in Modern Medicine, the relationship between insomnia and hypertension and coronary heart disease (CHD), understanding of Chinese Medicine on insomnia and hypertension and CHD, and the treatment of CHD or hypertension with insomnia in Chinese and Western Medicine. During normal sleep, our body can adjust the body through the complex neuroendocrine and hormone regulation mechanism. As this time, the level of sympathetic and endocrine activity reduced, and blood pressure decreased. Insomnia can induce or aggravate hypertension and CHD by increasing sympathetic activity, promoting the secretion of the hormone which can elevate blood pressure, causing endothelial injury and leading to insulin resistance. Finally, insomnia increases the morbidity and mortality of cardiovascular disease, indirectly.TCM has a unique understanding of hypertension, CHD and insomnia, and has its own characteristics and advantages in the treatment of the disease. Compared with simple Western Medicine or TCM, the combination of TCM and Western Medicine treatment can play a complementary role, enhance the efficacy of the same time reduce the incidence of side effects. Therefore, the combination of TCM and Western Medicine is the best choice for treatment of hypertension or CHD with insomnia.This part summarizes the influence of insomnia on hypertension and CHD, the research progress on the etiology, pathogenesis, syndrome differentiation and treatment of insomnia in TCM, and the treatment of hypertension and CHD with insomnia in combination of TCM and Western Medicine.The second part:clinical observation1. Clinical investigation of insomnia in patients with essential hypertension.Objective:To investigate the incidence of insomnia in patients with hypertension, and the TCM syndrome types distribution of hypertensive patients with insomnia.Methods:The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality of 158 patients with hypertension in the past 1 month. The basic information, blood pressure, body mass index, smoking and drinking history, past medical history of the patients were collected and registered. Enter data into Epidata database. Statistical analysis was carried out with SPSS 21.0 version.Results: ① A total of 158 cases of hypertension patients were investigated,60.13% of them with insomnia. ②Female was more likely suffer from insomnia than male (P<0.01).③ Patients with higher systolic blood pressure were more likely suffer from insomnia than those with normal systolic blood pressure (P<0.05).④The systolic blood pressure of patients with insomnia was higher than that of non-insomnia patients(P<0.01). ⑤The systolic blood pressure of patients that suffer from insomnia for more than 1 month was higher than that of non-insomnia patients (P<0.017). ⑥Patients with insomnia were more likely suffer from dizziness or headache than patients without insomnia (P<0.05).⑦The syndrome type distribution of essential hypertension patients with insomnia was yin-yang deficiency syndrome> yin deficiency and yang hyperactivity syndrome> blood stasis syndrome> phlegm dampness syndrome> liver-fire hyperactivity syndrome. Patients of yin-yang deficiency syndrome with the highest incidence of insomnia (77.78%), and patients of liver-fire hyperactivity syndrome with the lowest incidence of insomnia (20%).Conclusion: ①Insomnia was more common in patients with hypertension. ② Female were more likely suffer from insomnia than male. Patients with poor control of systolic blood pressure were more likely suffer from insomnia. The systolic blood pressure of hypertensive patients with insomnia was higher than those of hypertensive patients without insomnia.③ Suffering from insomnia for more than 1 month may cause a significant increase in systolic blood pressure. ④Hypertensive patients of yin-yang deficiency syndrome and blood stasis syndrome were with the highest incidence of insomnia.2. Observation of blood pressure and sleep quality improvement in hypertensive patients with insomnia treated with TCM.Objective:To observe the improvement of blood pressure and sleep quality in hypertensive patients with insomnia treated with TCM.Methods:30 cases of hypertension with insomnia patients in our outpatient department as observation group,30 cases of hypertension with insomnia patients in Department of Cardiology as control group. The two groups were treated with routine western medicine, and the observation group was treated with Traditional Chinese Medicine. Changes of blood pressure and PSQI score were observed before and after treatment.Results:① The primary and accompanied symptoms of the observation group were significantly improved (P< 0.01). The improvement of the accompanied symptoms in the observation group was better than that of the control group (P< 0.01). ② The observation group could significantly reduce the systolic and diastolic blood pressure (P< 0.01), and the systolic blood pressure decreased obviously than the control group (P< 0.01). ③ The improvement of PSQI score in the observation group was better than that of the control group (P< 0.01). The observation group was better than the control group in reducing the sleep latency and prolonging the actual sleep time (P< 0.05).Conclusion: ① TCM intervention had an obvious improvement on blood pressure and symptoms of hypertensive patients with insomnia. ②TCM intervention had different degrees of improvement on sleep latency, total sleep duration and sleep efficiency.