| Objective:(1)Summarizes and inherits the theoretical thinking and clinical experience of Professor Deng Tietao,s treatment of hypertension and provides useful reference for the clinical treatment of hypertension in Chinese medicine。(2)Under the guidance of the theory of "five internal organs",Professor Deng Tietao’s "five internal organs" theory,under the guidance of "heart and kidney" theory,the objective physical and chemical indexes of patients with different levels of hypertension and coronary heart disease and diabetes mellitus were observed,To "heart and kidney-related"theory to understand the high blood pressure and combined with a variety of cardiovascular complications to provide an objective basis for the guidance of treatment of hypertension and related complications of syndrome differentiation to provide a reference.Methods:Including from the June 2016 to March 2017 in Guangzhou University of Traditional Chinese Medicine First Affiliated Hospital of Cardiovascular Department of hospital inpatient and outpatient clinics in line with the inclusion criteria of hypertension in 310 cases,according to "Chinese medicine clinical research guidelines" Combined with Deng Lao experience,will be divided into liver yang hyperactivity syndrome,qi deficiency phlegm resistance card,blood deficiency syndrome,kidney essence deficiency card,blood stasis obstruction syndrome,yin and yang deficiency syndrome,phlegm mutual mutual evidence,sputum The blood pressure,renal function,fasting blood glucose,glycosylated hemoglobin,urinary albumin and creatinine,and cardiac color Doppler ultrasonography were measured in different grades of hypertension.And so on.Results:1.Among the 310 cases(163 males and 147 females),according to the card type distribution of patients withQi deficiency phlegm resistance type 111 cases(35.7%,58 cases of male and female 53),phlegm heat exchange junction 60(19.3%,41 cases of male,female 19 cases),kidney essence deficiency type 57 cases(18.3%,22 cases of male,female,35 cases),phlegm turbidity on one type of 38 cases(12.2%,male 20 cases,female in 18 cases),Liver yang hyperactivity type 20 cases(6.4%,9 cases of male and female in 11 cases),qi and blood deficiency type 9 cases(2.9%,5 cases were male,female 4 cases),9 cases of yin and yang deficiency(2.9%,6 cases of male,3 cases of female),obsessed with the blood stasis resistance type 6 cases(1.9%,male in 2 cases,female 4 cases).There is a significant difference in the overall distribution of each syndrome(P<0.01),The results of this test suggest that qi deficiency phlegm type,hlegm heat exchange junction,kidney essence deficiency type,phlegm on the type of hypertension is the highest distribution of syndromes.There was no significant difference in sex ratio between syndrome types(P=0.084<0.05),and also there was no significant difference in age between each syndromes(P=0.1744<0.05)。2.Multivariate regression analysis suggested that uric acid,hypertension,liver yang hyperactivity syndrome and urinary albumin/creatinine are related,and the statistical significance,the three are microalbuminuria/creatinine independent risk factors.Multivariate regression analysis showed that uric acid was associated with urinary albumin abnormalities and was statistically significant,and uric acid was an independent risk factor for urinary albumin abnormalities.Men,cholesterol,triglycerides,glycosylated hemoglobin,diabetes is a risk factor for urinary albumin/creatinine abnormalities.Men are more likely to have ACR abnormalities than women.With the increase in the risk factors of hypertension,the risk of heart and brain organ damage caused by the gradual increase.There were significant correlations between the number of cardiovascular disease and the degree of risk and heart and kidney damage.Which hypertension associated with diabetes and renal damage in urine microalbumin,urinary albumin/creatinine values are related.3.From the preliminary results of this trial,the total number of patients with hypertension combined with diabetes was 97(31.3%),and the total number of cases with non-combined diabetes was 213(68.7%).The distribution of syndromes of hypertension with diabetes mellitus was qi deficiency phlegm type(29 人,29.9%)>Kidney deficiency type(18 人,18.6%)>Phlegm and heat type(17 人,17.5%)>Phlegm on the type of disturbance type(13 人,13.4%)>Yin and yang deficiency type(6 人,6.2%)>Blood stasis type(5 人,5.2%)=Liver yang type(5人,5.2%)>Blood deficiency type(4 人,4.1%)。The results suggest that Qi deficiency phlegm may be an important cause of hypertension with diabetes,etiology and pathogenesis,phlegm may be one of the important pathogenic pathogens.4.From the preliminary results of this trial,the total number of patients with hypertension combined with renal damage was 91(29.4%),and the total number of cases with nonunion renal impairment was 219(70.6%).Among them,hypertensive disease with renal damage syndrome type distribution followed by qi deficiency phlegm type(26人,28.6%)>Phlegm and heat(20 人,22%)>Kidney deficiency(14 人,15.4%)>Phlegm on the type of disturbance(13 人,14.3%)>Yin and yang deficiency type(6 人,6.2%)>Blood stasis type(3 人,15.4%)。The preliminary results of this test suggest that Qi deficiency phlegm may be associated with renal damage with a major cause of kidney damage pathogenesis,phlegm may be one of the important pathogenic pathogens.5.From the preliminary results of this study,it is shown that the number of ACR abnormalities calculated by the classification of hypertension is higher than that of hypertension(Grade 3)(57.1%)>Hypertension Level 2(25.3%)>High Blood pressure 1(17.6%),consistent with the results of international research,can be considered that the higher the level of hypertension,resulting in more severe kidney damage,the greater the risk of kidney damage.6.From the preliminary results of this experiment,the distribution of urinary microalbumin/creatinine(ACR)abnormalities was counted based on the history of hypertension.The results showed that the number of cases of the hypertension’s history years between 0<N≤5(years)is is the largest(42 persons,46.2%)>the hypertension’ s history years between5<N≤10(years)(27 persons,29.7%)>the hypertension’s history years between 10<N≤15(years)(9 persons,9.9%)=the hypertension’s history years between15<N≤20(years)(9 persons,9.9%)>the hypertension’ s history years between 20(years)(4 persons,4.4%)。And the history of hypertension as a standard,Statistical urine microalbumin/creatinine(ACR)normal distribution of the law shows,the hypertension’ s history years between 0<N≤5(years)(118 persons,53.9%)>the hypertension’ s history years between5<N≤10(years)(60 persons,27.4%)>the hypertension’ s history years between15<N≤20(years)(21 persons,9.6%)>the hypertension’s history years between10<N≤15(years)(14 persons,6.4%)>the hypertension’ s history years between>20(years)(6 persons,2.7%)。Combined with the above statistical results suggest that Hypertension may be one of the most important factors affecting the occurrence of abnormal albumin/creatinine(ACR).7.From the above table,the results of this trial preliminary suggested that in all the included cases,a total of 186 cases of uric acid abnormalities(60%),uric acid normal 124(40%).Statistics show that the percentage of uric acid abnormalities appears in each syndrome Blood stasis type is 100(All the 6 persons)>Liver yang type is 90%(18 persons)>Yin and yang deficiency type is 77.8%(7 persons)>Phlegm and heat type is 68.3%(41 persons)>Blood deficiency type is 66.7%(6 persons)>Kidney deficiency type is 56.1%(32 人)>Qi deficiency phlegm type is 53.2%(59 persons)>Phlegm obstruction type is 44.7%(17 persons)。Statistics of the number of uric acid abnormalities/uric acid abnormalities in all syndromes(the total is 186 persons)shows that Qi deficiency phlegm type is 59 persons(31.7%)>Phlegm and heat type is 41 persons(22.0%)>Kidney deficiency type is 32 persons(17.2%)>Liver yang type is 18 persons(9.7%)>Phlegm on the type of disturbance is 17 persons(9.1%)>Yin and yang deficiency type is 7 persons(3.8%)>Blood deficiency type6 persons(3.2%)=Blood stasis type is 6 persons(3.2%).Combined with the above results suggest that hypertension associated with uric acid abnormalities in the various syndromes,phlegm may be caused by uric acid abnormalities of one of the important pathogens,suggesting that later clinical syndrome may have to consider the possibility of phlegm and blood stasis,Need to attract the attention of traditional Chinese medicine syndrome differentiation.8.From the above table of the experimental results of the initial prompt,included in ’the case data shown in this study,the number of patients with hypertension Grade 1 was 69(22.3%),the number of patients with hypertension Grade 2 was 114(36.8%),and the number of hypertensive patients with hypertension Grade 3 was 73(40.9%).The total number of cases with abnormal uric acid was 186(60%),and 124(40%)were normal.Among them,in hypertensive grade 1 the number of uric acid(UA)abnormalities is 39 persons(56.5%,21%),in hypertensive grade 2 the number of uric acid(UA)abnormalities is 65 persons(57%,34.9%),in hypertensive grade 3 the number of uric acid(UA)abnormalities is 82 persons(64.6%44.1%),Can be initially thought that with the increase in blood pressure levels,which will increase the proportion of uric acid abnormalities,suggesting that blood pressure grade is an important reason leading to abnormal uric acid.Conclusion:In this study,patients with essential hypertension,qi deficiency phlegm-type distribution of the largest number of cases,indicating that qi deficiency phlegm is an important type of primary hypertension pathogenesis.Uric acid,high blood pressure classification,liver yang hyperactivity syndrome is caused by hypertension induced renal injury indicators ACR abnormalities of independent risk factors,and has statistical significance.Male,cholesterol,triglyceride,glycosylated hemoglobin,diabetes is an influential factor of ACR,male is more prone to ACR abnormalities than women. |
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