Hypertensive Renal Damage Clinical Investigation And Research Syndromes

BackgroundHypertension is more common in cardiovascular disease, its incidence is increasing year by year. The damage of heart, brain, kidney,which caused by hypertension, are the major cause of death and disability. The damage of kidney is one of the main target organ, caused by hypertension. Studies have shown, about18%of hypertensive patients will eventually occur renal insufficiency, at the same time, along with the rise of the disease incidence rate, incidence of ESRD is also on the rise caused by hypertension; In the past10years, incidence of ESRD in America increase by rate of9%year,ESRD new patients caused by hypertension accounted for28%.In recent years, the domestic and foreign research discovery, that is not far enough for the simple application of antihypertensive drugs to protect renal function. Therefore, emphasizing the understangding of hypertension nephrosclerosis(HN)in traditional chinese medicine(TCM), and applying the treatment of syndrome differentiation of TCM is more important to prevent, even reverse for early hypertensive renal damage.ObjectiveRetrospective study of the patients of HN clinical status and the distribution of TCM syndrome in hospital.MethodsProfessionals collect the hospitalized medical records from the renal department of Dongfang hospital of Beijing University of Chinese Medicine from January1,2004to December31,2013, which were definitely diagnosed of hypertensive renal damage or hypertensive nephropathy, fill in the information collection table for hypertensive renal damage patients in renal department of Dongfang hospital canonically, generalize the ordinary, hypertensive, TCMsyndrome and treatment situation etc., apply the statistics for correlation analyzing on the collected data, approach the characteristics, inherent law of the TCM pathodenesis and syndrome differentiation and further reveal the hypertensive renal damage in the traditional Chinese medicine and western medicine clinical status.Results1.This study collectes119cases, including67cases of male, female52cases, male to female ratio was1.29:1,mean age is64.05±12.66years, the majority is from50to80years old.2.In119cases of hypertension grade diagnosis,3in the majority, accounting for80.67%; usually blood pressure control accounted for36.13%, not be accounted for41.18%, did not monitor, accounted for22.69%. The average duration of hypertensive renal damage is16.47±13.75years.3.Hypertensive renal damage in medical examination found that is the majority, accounting for57.14%. Diagnosis of TCM, chronic renal failure is the majority, accountingfor42.86%; followed by the turbid erine, edema; dizziness, chronic kidney wind, bleeding, pain, stranguria, dyspnea, chest fullness are also visible. The TCM diagnosis for more complex syndrome, deficiency excess syndrome is the main syndrome, accounted for79.83%.4.Summary of nearly10years of history, except repetition inpatients, annual inpatients from2004to2013are3cases,14cases,6cases,6cases,10cases,3cases,14cases,23cases,18cases,22cases, the basic trend is upward.5. Medication treatment, the option is mostly combined drugs, CCB is the most widely used, accounting for78.99%; ACEI/ARB accounting for62.19%, and found that the proportion of the basic use of RAS blocking agent showed a rising trend year by year.Conclusions1.There is no specific symptome in early stage of hypertensive renal damage, physical examination is the main found reason; control and course of blood pressure are the important causes of hypertensive renal damage.2.Diagnosis of TCM is chronic renal failure mostly, turbid urine, edema are also more seen,the disease mainly in the kidney, liver and spleen are closely related, disease with deficiency and excess, major deficiency is kidney and spleen, at the same time, combining the blood stasis, phlegm, qi stagnation, pathogenic wind of pathogenic factors.3. Clinically, RAS blocking agent has gradually become standardized medicine for the hypertensive renal damage.