Cross Sectional Study Of TCM Syndroms And Clinical Features Of Postprandial Hypotension In The Hospitalized Elderly

Objective:To investigate the incidence and clinical characteristics of postprandial hypotension (PPH) in the elderly patients in the Geriatrics Department of Fujian Medical University Affiliated Union Hospital, including the distribution of chronic diseases and the impact of internal medicines on PPH. And investigate the classifications of TCM syndromes of the enrolled elderly patients.Methods:117cases of aged patients who were hospitalized in the Cadre Ward from2012.02.16to2013.12.22were enrolled, and the patients’clinical data were collected, including the general condition, Internal Medicine disease, laboratory data and auxiliary examination. Supine blood pressure was measured on the right arm with the sphygmomanometer. The BP readings were recorded before meal and15,30,60,120min after meal. PPH was defined as a meal-induced systolic BP decrease of20mmHg. The occurrence rate of PPH was calculated. And TCM syndromes were analysed in all enrolled patients.Results:1.59pateints were confirmed as PPH, with the incidence of50.42%.Breadfast was the most liable meal. There were38.98%of PPH patients who suffered from2meals or3meals. Posterior circulation ischemia, Parkinson’s disease, and carotid atherosclerosis were more commom in PPH group than non-PPH group. There was no significant difference in diabetes, dementia, hypertension, coronary heart disease between the two groups.There was higer plasma cholesterol level but lower serum sodium level in PPH group compared with those in non-PPH group.There was no significant difference in hemoglobin, triglycerides, low-density lipoprotein, high density lipoprotein, potassium, left ventricular heart ejection fraction between the two groups. There were more patients taking RASI drugs, Pramipexole and dihydrochloride in PPH group, but there was no significant difference in taking a-blockers,(3-blockers, calcium antagonists, combination therapy of antihypertensive drugs,lipid-lowering drugs,sedatives,madopar between the two groups.2.There were differences in the prevalence of vertigo(76.70%VS17.24%) and Tremor syndrome (23.73%vs8.63%)(P<0.05) but no significant difference in apoplectic sequelae, dementia, Chest pain syndrome, diabetes between the two groups.There was a significant differences.between the two Vertigo groups in TCM diagnosis of Liver and kidney yin deficiency(74.14%VS10.34%)(P<0.05).There was no significant differences in dementia between marrow deficiency syndrome+liver and kidney yin deficiency and marrow deficiency syndrome.There was no significant differences.in apoplectic sequelae between marrow deficiency syndrome+liver and kidney yin deficiency and marrow deficiency syndrome. There was no significant differences in Tremor syndrome between Liver and kidney yin deficiency+marrow deficiency syndrome+Yang within the dynamic wind and Liver and kidney yin deficiency+Yang within the dynamic wind. There was no significant differences.in Chest pain syndrome between Phlegm in heart vessel+qi stagnation in chest and Phlegm in heart vessel+Heart Qi decline. There was no significant differences.in Diabetes between Qi and Yin Deficiency and non-Qi and Yin Deficiency.There was more TCM diagnosis and Yang within the dynamic wind in PPH group than the one in no-PPH. There was no significant differences.in marrow deficiency syndrome, Heart Qi decline, qi stagnation in chest, Phlegm in heart vessel, Qi and Yin Deficiency between PPH group and non-PPH group.Conclusion:1.The incidence of PPH in the Geriatics Department was50.42%. Posterior circulation ischemia,Parkinson’s disease, carotid atherosclerosis are more common in PPH group compared to non-PPH group. The risk of PPH may be increased by using Control of blood pressure drugs, especially diuretics and Combination therapy.2.Vertigo is the main TCM diagnosis and TCM master card is Liver and kidney yin deficiency in PPH group.There is a high incidence of Chest pain syndrome in total survey population with no Significant differences between the two groups, and TCM main symptom was Phlegm in heart vessel+qi stagnation in chest.