| Clinical investigation1. ObjectivesInvestigate the characters of the symptoms of the blood stasis syndrome in hypertensive patients with abnormal blood fat, mainly in different genders, age grades, course grades, blood fat level, cardiovascular risk stratification, and other types of syndrome combining with, and illuminate its disposition rule.Investigate the discrepancies in life quality between the hypertensive patients with abnormal blood fat to whom with non-blood stasis.Provide theory basis for promoting blood circulation by removing blood stasis and decreasing blood pressure and the blood fat level, and improve the quality of life of hypertension patients with abnormal blood fat.2. MethodsHypertensive patients with abnormal blood fat ranging from age 18 to age 75, attending outpatient clinics and inpatients of Guang'an Men Hospital of general internal department were interviewed. The diseases types of the patients were among hyperactivity of liver-yang syndrome, yin deficiency of liver and kidney syndrome, liver-wind and phlegm syndrome and deficiency of asthenia of both the spleen and kidney syndrome. They were also classified with the blood stasis syndrome or non-blood stasis one.Hypertensive life assessment instrument established by Professor Du Xunming of Hubei Medical University and questionnaire made by the author were adopted in these interviews. Trained doctors completed the questionnaire regarding demographics, treatment of history, symptoms, signs and quality of life issues and performed examination. Data were managed and statistically analyzed by software SPSS 19.6. Two groups of samples in normal distribution were investigated by T test and multi-samples by variance analysis. Abnormal distribution Data were investigated by NPAR test, such as Mann-Whitney test, Kruskal-Wallis test, and Chi-square analyses. 3. Results3.1 General conditionsFrom December 2010 to April 2011,300 hypertensive patients with abnormal blood fat were enrolled while 218 (72.6%) had blood stasis syndrome, hyperactivity of liver-yang syndrome in 39 case (13%), yin deficiency of liver and kidney syndrome in 76 case (25.33%), liver-wind and phlegm syndrome in 114 case (38%) and deficiency of asthenia of both the spleen and kidney syndrome in 71 case (23.67%).3.2 The characters of the symptoms of the blood stasis syndrome in hypertensive patientsPrevious study pointed out it includes headache, neck rigidity, chest distress, chest pain, palpitation, extremity Anaesth, hemiparalysis, dark red of oral lip, orbit, palm of hand and body of the tongue, unsmooth pulse.3.3 The characters of the symptoms of the blood stasis syndrome in abnormal blood fat patientsPrevious study pointed out it includes headache, dizziness, chest distress, chest pain, palpitation, extremity anaesth, chest and hypochondrium, dark red of body of the tongue, unsmooth pulse.3.4 The characters of the symptoms of the blood stasis syndrome in hypertensive patients with abnormal blood fat.3.4.1 Distribution of symptoms and signsThere are statistics difference, (P<0.05), comparing the non-blood stasis syndrome ones to the patients with blood stasis syndrome developing headache, dizziness, neck rigidity, chest distress, breath holding, chest pain, palpitation, extremity anaesth, facial distortion, dysphasia, hemiparalysis, complexion darkness, dark red of oral lip, orbit, palm of hand and body of the tongue, unsmooth pulse. So it can be inducted as the characters of the symptoms and physical signs of the blood stasis syndrome in hypertensive patients with abnormal blood fat.3.4.2 The characters of different age gradesComparing with young and middle age groups and elder groups, the incidence rate, the severity level, the numbers of the syndrome and the physical sign syndrome of blood stasis are significantly different (P<0.01). All elder groups> young and middle groups.3.4.3 The characters of different course gradesComparing with the groups below 10-year-course grade, the ones exceeding 10-year-course grade are significantly different (P<0.01) in the incidence rate, severity level, the numbers of the syndrome, and physical sign syndrome of blood stasis. All groups exceeding 10-year-course grade> the ones below.3.4.4 The characters of different cardiovascular risk stratification of hypertensive.Comparing with the groups in midst and high danger, the groups in very high degree are significantly different (P<0.01) in the incidence rate, severity level, the numbers of the syndrome and physical sign syndrome of blood stasis. All very high danger groups> the ones in midst and high degree.3.4.5 The characters of different cardiovascular risk stratification of abnormal blood fatComparing with the groups in low and midst danger, the groups in high degree are significantly different (P<0.01) in the incidence rate, severity level, the numbers of the syndrome and physical sign syndrome of blood stasis. All high danger groups> the ones in low and midst degree.3.4.6 The characters of different blood fat levelComparing the TC level step-up groups with marginal step-up and suitable groups, the incidence rate and severity level of blood stasis are significantly different (P<0.05). Both step-up groups are more than marginal step-up and suitable groups.Comparing the LDL level step-up groups with marginal step-up and suitable groups, the incidence rate and severity level of blood stasis are significantly different (P<0.05). Step-up groups> marginal step up and suitable groups.3.4.7 The characters of different types of syndrome combining with blood stasisThe incidence rate and severity level of blood stasis of the four types of investigated groups are significantly different (P<0.05). The type of asthenia of both the spleen and kidney is the highest in both aspects, while the type of hyperactivity of liver-YANG is on the contrary. 3.5 The influence of the quality of the blood stasis syndrome in hypertensive patients with abnormal blood fatBlood stasis syndrome scored lower in multiple liner regression analyses in most questions questionnaire than those without blood stasis syndrome on the quality of life (P<0.05), especially in some aspects like physiological symptoms, physical symptoms, sexual function activity, anger and energy, sleep state,work performance, daily life quality and cognitive function (P<0.05).3.5.1 The severity level of blood stasis and quality of lifeAccording to the whole score of syndrome of blood stasis, it was divided into three groups. There are significant differences in whole score of life quality scale, daily life quality and cognitive function, (P<0.05), exceeding 20-score groups< 10-20 score groups< below 10-score groups.3.5.2 Different cardiovascular risk stratification and life qualityThe very-high-danger group compares with midst and high danger-group and the whole score of life quality scale, daily life quality and cognitive function are all significantly different (P<0.01). Very-high-danger group< midst and high danger group.3.5.3 Different types of syndrome which combine with blood stasis and quality of lifeQuality of life of the four types are significant difference in the whole score of life quality scale, daily life quality and cognitive function (P<0.05), asthenia of both the spleen and kidney with blood stasis-group< yin deficiency of liver and kidney with blood stasis-group< liver-wind and phlegm with blood stasis-group< hyperactivity of liver-YANG with blood stasis-group.3.6 SummaryThe characters of the symptoms of the blood stasis syndrome in hypertensive patients with abnormal blood fat are included in three aspect:Firstly, the characters of the symptoms and physical sign of the patients includes headache, dizziness, neck rigidity, chest distress, breath holding, chest pain, palpitation, extremity anaesth, facial distortion, dysphasia, hemiparalysis, complexion darkness, dark red of oral lip,orbit, palm of hand and body of the tongue, unsmooth pulse; Secondly, the incidence rate, severity level, the numbers of the syndrome and physical sign of blood stasis are increasing along with age, course, and cardiovascular risk stratification of the patient; Thirdly, the incidence rate and severity level and the number of the syndrome and physical sign of blood stasis of the type of asthenia of both the spleen and kidney are highest, while the type of hyperactivity of liver-YANG is on the contrary.Quality of life in blood stasis syndrome is lower than those who without blood stasis syndrome. As the blood stasis serious level and cardiovascular risk stratification of the patient are high, the quality of life is lower. Quality of life in the type of asthenia of both the spleen and kidney with blood stasis patients are low. It coincides with the incidence rate and severity level of the patients with asthenia of both the spleen and kidney is highest.4. ConclusionComparing with previous study, this satud suggests that not only the numbers of the symptoms and physical sign of the blood stasis syndrome in hypertensive patients with abnormal blood fat are more than those with normal blood fat,but also the incidence rate, severity of blood stasis level are higher, and the blood stasis emerge early. Furthermore the quality of life of the blood stasis syndrome in hypertensive patients with abnormal blood fat is lower than those with normal blood fat.Blood stasis is not only one of the most important pathogenesis but also influencing factor in the quality of life for the hypertensive patients with abnormal blood fat. It is very important that hypertension patients with abnormal blood fat is treated with promoting blood circulation to remove blood stasis early on the basis of determination of treatment based on differentiation of syndromes. Which is new notion of traditional Chinese medicine to improve the quality of life for the hypertensive patients with abnormal blood fat. |
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