| Hypertension (HT) is a common major chronic disease, and it is one of the main risk factors of coronary heart disease or cerebrovascular disease. The community prevention is an important measure to control hypertension. Due to the differences in living conditions, work environment and diet structure, the characteristics of TCM Syndromes of city and rural community population with hypertension may also differ. For better implementation of the prevention and treatment via Chinese medicine it is necessary to carry out prospective study of hypertension syndrome characteristics. The study will investigate and analyze the syndrome characteristics difference in the urban and rural areas of Beijing, thereby explaining for the pathogenesis, symptoms and treatment of hypertension. The study would also present a preliminary idea for prevention and treatment of disease through Community Medicine, in hope of improving the level of prevention and treatment of hypertension in Community Medicine.Research Methods:(1)Residents from the Chaoyang District Anhuili South Village and Shunyi District Renhe Town who fulfilled the requirements are selected and classified into the city and rural groups.(2)Upon completing the "Community Hypertension Clinical Syndromes" questionnaire, selected residents will go through the acquisition process of medical history, clinical symptoms, including tongue and pulse.(3)They are to be divided into the liver yang hyperactivity, hyperactivity of liver fire, liver qi stagnation, blood stasis, phlegm, and Qi deficiency, blood deficiency, yin deficiency of empirical, deficiency of Yang, deficiency of the liver, kidney and heart, lung deficiency, and spleen stomach deficiency syndrome.(4) Utilizing chi-square test and t-test, the epidemiological characteristics and syndromes law were studied through comparative study of urban and rural communities hypertension.Result:A total of200cases were selected, with100cases each from the city and rural communities,92male cases (46%),108female cases (54%), between the age of35to87years old, mean age (58.6±11.9) years old.(1) The difference between the epidemiology of two groups: aside from diabetes related complications, there are little differences in terms of gender, disease duration, grade of hypertension and hypertension clinical risk stratification. In terms of the average age of subjects (61.5±12.5PS55.7±11.6), lack of physical activity ratio (39%PS22%), abdominal obesity rate (61%PS47%), diabetes mellitus (41%PS23%), the proportion of body mass index (26.7±4.1PS25.7±4.5), the awareness rate of hypertension (67%PS40%), the treatment rate (36%PS18%) and the control rate (10%PS4%), the city group presents with higher readings than the rural group. On the other hand, the rural group presents with significantly higher reading than that of the city group in terms of salt intake ratio (41%PS24%).(2)The hypertension syndromes distribution: in6standard empirical, hyperactivity of liver Yang syndrome has the highest proportion (130cases,65%), followed by liver fire hyperactivity (107cases,53.5%) and blood stasis syndrome (99cases,49.5%). Whereas phlegm (56cases,28%), qi stagnation (51cases25.5%) and endogenous liver wind (44cases,22%) constitutes a lower proportion. Among the4deficiency syndromes, yin deficiency appeared in the highest proportion (99cases,49.5%), followed by qi deficiency (84cases,42%), whereas yang deficiency (24cases,12%) and blood deficiency (9cases,4.5%) occurring proportions are low. In the6viscera deficiency syndrome, kidney deficiency appeared in the highest proportion (150cases,75%), whereas the heart qi deficiency (119cases,59.5%), liver deficiency syndrome (106cases,53%), gastric qi (23cases,11.5%), spleen deficiency cases(10cases,5%) and lung qi deficiency (9cases,4.5%) constitutes a lower proportion.(3)The comparison of hypertension syndrome distribution between the two groups: Using the chi square test, phlegm of city group was significantly higher than rural, the differences between the city group and the rural group in phlegm dampness ratio (40%PS16%) showed statistical significance (P<0.05), while the hyperactivity of liver yang, liver fire hyperactivity, comparison of endogenous liver wind syndrome, qi stagnation, blood stasis syndrome distribution showed no statistical significance (P>0.05). Yin deficiency of city group was significantly lower than the proportion of rural group (43%PS56%)(P<0.05), while the distribution of qi deficiency, yang deficiency, blood deficiency showed no statistical significance (P>0.05). Kidney deficiency and liver deficiency of City group was significantly lower than the rural group (64%PS86%、46%PS60%)(P<0.05), while heart qi deficiency, spleen deficiency, stomach deficiency, lung deficiency showed no statistical significance (P>0.05).Conclusion:(1) Hypertension mainly presents as empirical deficiency. The core pathogenesis of hypertension are liver kidney yin deficiency, yin deficiency and yang hyperactivity. The disease mainly manifests in the upper orifices and it is closely related to the heart, liver and kidney. Qi deficiency and blood stasis is commonly observed in disease progression of hypertension;(2)There is a significant difference in the epidemiological characteristics of hypertension in Beijing city area as compared to the countryside;(3) The proportion of yin deficiency, kidney deficiency, liver deficiency was significantly higher in the rural population than the city population, while the inverse presents in phlegm dampness syndrome;(4)The principle of TCM treatment of hypertension is the "prevention of disease and disease progression", with a core value of preventing various risk factors for hypertension. During the onset and initial stages of hypertension, focus should be placed on the prevention and treatment of yin deficiency and heart, liver, kidney deficiency. For chronic cases, there should be preventive measures for qi deficiency and blood stasis syndrome. For the urban population, it should attach importance to prevention and treatment of phlegm, while rural people should pay more attention in the prevention and treatment of liver and kidney deficiency. |
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