| As China has entered the aging society, the health problems of the elderly is paid more attention than ever.Cardiovascular disease is the major diseases that endanger the health of the elderly,hypertension is a major risk factor for incidence and death of stroke and coronary heart disease. So health research and prevention of hypertension of the elderly is particularly important. In recent years, western medicine research in hypertension has developed quickly, however traditional Chinese medicine research is still unsatisfactory by comparison.Especially, complication of the elderly who suffered from hypertension is more than young ones,which result in complex TCM syndrome. TCM syndrome type of hypertension in the elderly is researched less and stay in the primary stage. In summary, research about TCM syndrome typing of elderly hypertension have great significance.Objective:The aim of thesis to preliminarily explore TCM syndrome distribution rule of hypertension in the elderly in hospital to provide a reference for clinical TCM syndrome typing.Methods:Through retrospective approach,cases of inpatients in department of Geriatrics and Cardiology of Dongzhimen Hospital affiliated Beijing University of Traditional Chinese Medicine from November11,2010to November1,2012are collected. After data collection, two doctors whose titles for the attending physician or associate chief physician or chief physician are in charge of TCM symdrome typing.Medical records which can not be classified as these four standard patterns of syndrome are to be removed. Main syndrome type is the research object rather than other combined types. Data entry and statistical analysis is the last step.Results:(1)TCM syndrome typing frequency descending order in the elderly’s hypertension disease:yin deficiency and yang excess(38,5%)>retention of phlegmatic dampness(31%)> deficiency of both yin and yang(22%)> overabundant liver-fire(8.5%).(2)Retention of phlegmatic dampness is accounted for47.6%in the45-54age segment.Deficiency of both yin and yang is s accounted for36.6%in the segment of>75years of age. The difference was statistically significant.Course of overabundant liver-fire is8.53±6.125years,that of deficiency of both yin and yang is14.41±10.368years. The difference was statistically significant.(3)Retention of phlegmatic dampness is accounted for30.3%in dipper circadian rhythm.Yin deficiency and yang excess is accounted for39.1%in non-dipper rhythm.Yin deficiency and yang excess is accounted for44,6%in inverted transformation. The difference was statistically significant.(4) TCM syndrome and ambulatory blood pressure indicators:systolic blood pressure values of yin deficiency and yang excess is the highest, that of retention of phlegmatic dampness is the lowest; diastolic blood pressure values of overabundant liver-fire is the highest, that of deficiency of both yin and yang is the lowest; pulse pressure values of both deficiency o both yin and yang and yin deficiency and yang excess is higher than retention of phlegmatic dampness or overabundant liver-fire.(5) logistic regression of TCM syndrome typing:There is a negative correlation between overabundant liver-fire and age>75、BMI values increased、non-dipper circadian rhythm. There is a positive correlation between yin deficiency and yang excess and duration of more than20years、non-dipper circadian rhythm、E/A ratio elevated. Syndrome which ages is55-64or65-74,especially≥75is likely to be deficiency of both yin and yang of kidney. There is a negative correlation between retention of phlegmatic dampness and BMI values elevated、drinker、non-dipper circadian blood pressure、E/A ratio increased.Conclusion:The most common TCM syndrome typing of hypertension in the elderly is yin deficiency and yang excess,followed by retention of phlegmatic dampness, deficiency of both yin and yang, overabundant liver-fire. There is a relationship between TCM syndrome typing and age, duration, blood pressure circadian rhythm,, ambulatory blood pressure indicators. |
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