Primary Hypertension With Tcm Syndrome Associated With Carotid Atherosclerosis Study

Objective:Hypertension with Carotid Atherosclerosis(CAS) is a common disease which is seriously harmful to people’s health. The interventional diagnosis and treatment of hypertension with AS has played an increasingly important role in recent years.Syndromes are the objects for differential diagnosis of traditional Chinese medicine(TCM) and the basis of treatment. So we begin to our clinical study from Syndromes.The study observe the peculiarity and the influential factors of the syndromes of hypertension with carotid atherosclerosis(CAS).And we analyze traditional Chinese medicine (TCM) syndromes of hypertension with carotid atherosclerosis(CAS) so as to explore the pathogenesis of hypertension with carotid atherosclerosis(CAS) and the early diagnosis and treatment of the disease.Methods:The objects of research are195inpatients with Essential hypertension in the ward of department of TCM, Peking University People’s Hospital, January2009-December2010.All of the selected inpatients were divided into three groups according to the examination results of color doppler ultrasound of carotid artery:the normal group (IMT<0.9mm and no plaque),the Intima-mdiathickness group(0.9mm≤lMT<1.2mm and no plaque shaping),the plaque group(IMT≥1.2mm and/or plaque shaping).the collections of syndromes of TCM with the four examination and the clinical record of clinic investigation of every patient were Completed by experienced and specially trained doctors. Including Triglyceride, Total Cholesterol, High Density Poprotein Cholesterol, Low Density Poprotein Cholesterol,Uric acid etc.were collected from venous blood samples of patients. Statistical analysis using the Statistical software of SPSS14.0.Descriptive statistical analysis, Measurement datas with Homogeneity of variance are described by mean addition±tandard deviation. Count data were analyzed by Chi-square test.Taking risk analysis to study in relative risk odds ratio (Odds ratio). P<0.05considered significant difference.Results:(1) Distribution of syndromes:The most common syndromes of the152inpatients in the group of carotid atherosclerosis (including the Intima-mdiathickness group and the plaque group) are phlegm-stasis(114cases,75%of total).besides,blood-stasis(90cases,59.2%of total), yin-deficiency(78cases,55.9%of total)are also relatively common syndromes.qi-deficiency syndrome. While the most common syndromes of the43inpatients in the normal group are also phlegm-stasis(25cases,58.1%of total), yang-hyperactivity(19cases,44.2%of total)are also relatively common syndromes.(2) Proportions of syndromes:The statistical analysis shows that the percentage of blood-stasis and yin-deficiency of the group of CAS are higher than that of the nomal group (P<0.05), while while the percentage of yang-hyperactivity of the group of CAS is lower than that of the nomal group (P<0.05), considered significant difference.(3) Combination of syndromes:The most common combination of syndromes among the152inpatients in the group of carotid atherosclerosis Patients is the combination of three-syndromes(43.42%of total).Besides, the combination of two-syndromes(30.92%of total)and four-syndromes(21.05%of total)are also relatively common, while only a few combination are single-syndrome or five-syndromes. The law of changes of syndrome-combination:the syndrome of qi-yin deficiency and the syndrome of intermingled phlegm and blood stasisare are the most common syndrome-combinations.so yin-deficiency or qi-deficiency intermingled phlegm or blood stasis are the most basis of the changes in hypertension with CAS.(4)Influential factors of causing hypertension with CAS:The relative risk odds ratio analysis shows that The syndrome of phlegm-stasis, blood-stasis, yin-deficiency syndrome are the dangerous deficiency-syndromes of the viscera of essential hypertension with CAS.Conclusion:(1)Phlegm-stasis, blood-stasis, yin-deficiency syndrome are the most common syndromes of hypertension with carotid atherosclerosis. The yin-deficiency and the syndrome of intermingled phlegm and blood are all the basic pathological changes of hypertension with carotid atherosclerosis(2) Hypertension with carotid atherosclerosis has different clinical TCM syndromes in different stages of development.The law of changes of syndrome-combination:the syndrome of qi-yin deficiency and the syndrome of intermingled phlegm and blood stasisare are the most common syndrome-combinations.(3) The syndrome of phlegm-stasis, blood-stasis, yin-deficiency are the dangerous deficiency-syndromes of the viscera of essential hypertension with carotid atherosclerosis.The intervention on syndrome of phlegm-stasis, blood-stasis, yin-deficiency of hypertension Patients should be important carotid atherosclerosis prevention methods.