Analysis Of The Distribution Pattern And Related Factors Of 126 Elderly Patients With Orthostatic Hypotension

Objective:Through the research of this subject,we will explore the distribution and regularity of TCM syndromes in elderly patients with orthostatic hypotension and the characteristics and clinical manifestations of TCM Syndromes,understand the relationship between the occurrence and development of the disease and the distribution of TCM Syndromes,and provide an objective basis for the distribution of TCM Syndrome and some basic informations for further epidemiological study of the disease.Methods:Draw up the clinical questionnaire for the elderly orthostatic hypotension.Based on the investigation and examination of the elderly patients with orthostatic hypotension in China-Japan Friendship hospital and Dongzhimen hospital,we'll observe the characteristics of TCM syndrome in elderly patients with orthostatic hypotension,find out the regularity of TCM syndrome differentiation,and analyze the correlation between the disease and age,hypertension,ambulatory blood pressure and various complications.Results:The incidence of orthostatic hypotension in the elderly is hidden,and the most common symptoms are dizziness,weakness and decreased activity.Analysis of 126 cases of patients with the disease:?there are 4 main TCM syndromes were Qi and yin deficiency(63.5%),deficiency of spleen and kidney(12.7%),phlegm and blood stasis(9.5%),yin-yang deficiency(7.1%),In the type of Qi and yin deficiency,the subtype of blood stasis accounted for nearly half.the others make up a smaller part including deficiency of yin and hyperactivity of Yang,damp heat and heart-kidney imbalance and so on.?The prevalence of orthostatic hypotension in elderly increased with age,which 26 cases were 60-69 years old(20.6%),35cases were 70-79 years old(27.8%),54 cases were 80-90 years old(42.9%)and 11 cases were over 90 years old(8.7%).? There were 46 cases with no history of orthostatic hypotension(36.50%),no more than 3 years in 63 cases(50%),and more than 3 years in 17 cases(13.5%).? there are mental workers in 90 cases(71.40%),manual workers in 24 cases(19%),uncertainty in 12 cases(9.50%).? A total of 126 patients,majority are accompanied with 3 or more underlying diseases,and more than half suffer from hypertension(82 cases,65.1%)and cerebral infarction(80 cases,63.5%).78 patients completed the ambulatory blood pressure monitoring,no dipper blood pressure accounted for the vast majority(72 cases,92.3%).?There is a great difference in the distribution of syndrome types over 70 years old(P<0.05),Qi and yin deficiency and the subtype of blood stasis are critical.based on various types of occupation;no significant differences in the distribution of syndromes(P>0.05),there is significant difference in the distribution of the subtypes of blood stasis in patients with orthostatic hypotension and hypertension(P<0.05),while other syndromes are no difference;there is significant difference in the distribution of Qi and yin deficiency and the subtypes of blood stasis in patients complicated with cerebral infarction(P<0.05),while other syndromes are no difference.Conclusion:Qi and yin deficiency,deficiency of spleen and kidney,phlegm and blood stasis,yin-yang deficiency are the four main basic syndromes of orthostatic hypotension in the elderly,which Qi and yin deficiency syndrome is the most important orthostatic hypotension syndrome.The subtype of blood stasis accounts for nearly half of Qi and yin deficiency type,blood stasis is the most important pathological factors.The TCM pathogenesis characteristics of orthostatic hypotension in the elderly is insidious onset,onset time cannot correctly estimate,headache,fatigue,shortness of breath,dry stool,mouth parched and tongue scorched urination are the main clinical symptoms of orthostatic hypotension in the elderly.With the increase of age,the prevalence of orthostatic hypotension in elderly patients is increasing.Orthostatic hypotension in elderly patients always have more than 3 kinds of complications,in all the complications,which hypertension and cerebral infarction disease account for more than half,whereas the proportion of diabetes,coronary heart disease,renal insufficiency,atherosclerosis and other common underlying diseases in elderly orthostatic hypotension are relatively low.There is a close correlation between hypertension,24h ambulatory blood pressure abnormality and orthostatic hypotension,which may be the different developmental stages of the same pathogenesis.Cerebral infarction and orthostatic hypotension interact with each other to promote brain damage and affect cognitive function.The older,qi and yin deficiency and the subtype of blood stasis syndrome are more obvious.