| PurposesTo investigate the relationship between the distribution of TCM syndromes of essential hypertension and metabolic enzymes or receptor gene polymorphisms and clinical physicochemical indexes of commonly used three types of hypertension drugs,in order to guide the development of BP regimens through TCM syndrome differentiation and TCM syndromes provide accurate and quantifiable evidence.MethodIn this study,a cross-sectional survey method was used to investigate the health status of 458 patients with essential hypertension and 50 physical examinations in the Department of Cardiology and Chinese and Western Heart Disease Units in the China-Japan Friendship Hospital between September 2017 and February 2018.Patient information collection,including demographic information,risk factors,TCM syndrome information,hypertension drug receptors or metabolic enzyme genes(including beta blocker genes CYP2D6,ADRB1 G1165C;angiotensin ? receptor blocker gene CYP2C9,AGTR1 A1166C;angiotensin-converting enzyme inhibitor gene ACEI/D),blood biochemistry(glucose lipids,uric acid,homocysteine,high-sensitivity C-reactive protein,urea),and the like.Gene detection was detected by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).Analyze the patient's dialectical and basic conditions,the genotypes and gene frequencies of 5 genetic tests,the correlation of clinical physicochemical indexes,the genotypes and allele frequencies of the genes in patients(diseased group)and healthy people(control group))Differences,etc.Data processing was analyzed using spss22.0 statistical software.Result1?In 458 hypertensive patients,the syndrome distribution was as follows:166 cases(36.2%)of Profuse expectoration and retention of dampness syndrome>133 cases(29.0%)of Hyperactivity of yang due to deficiency of yin>118 cases of yin and yang deficiency(25.8%)>41 cases(8.9%)of Liver-fire syndrome.The blood lipid,blood uric acid,and BMI were significantly higher than those of other syndromes in patients with Profuse expectoration and retention of dampness,and the difference was statistically significant(P<0.05);The levels of blood glucose and urea nitrogen in patients with yin and yang deficiency were higher than those in other syndromes,and the difference was statistically significant(P<0.05);The proportion of patients with yin and yang deficiency with cerebrovascular disease was significantly higher than those with other syndromes,and the difference was statistically significant(P<0.05);The proportion of smoking in patients with Profuse expectoration and retention of dampness was higher than that of other syndromes,and the difference was statistically significant(P<0.05).Patients with a family history were more likely to have Liver-fire syndrome than other syndromes,with statistical differences(P<0.05).2?Comparison of drug genotypes and allele distribution in patients with hypertensionThe D/D genotype of ACE genotype in the diseased group was significantly higher than that in the control group(P<0.05).The diastolic blood pressure level of the D/D genotype was higher in the diseased group than in the I/I group.Type of patients increased,the difference was statistically significant.There was no significant difference in the genotypes of ADRB1 gene between the diseased group and the control group,but the frequency of Gly389 alleles in the hypertensive patient group was higher than that in the control group,and the difference was close to statistical significance(P=0.06).Patients with Arg389 allele had higher mean diastolic blood pressure than those with Gly389 allele,and the difference was statistically significant(p<0.05).There was no significant difference in genotypes and allelic distributions of CYP2D6.There was no significant difference in genotypes and allelic distributions of AGTRl and CYP2C9 between the diseased group and the control group.There was no significant difference in mean blood pressure among the genotypes.The HCY level of AGTR1 genotype AA was lower,with statistical significance(P<0.05).3?ACE genotypes for D/D syndromes were higher than those with other syndromes,and the differences were statistically significant(p<0.05).Regression analysis showed D/D type(RR=12.625,95%CI:3.608-44.182,P<0.05),I/D type(RR=3.76,95%CI:1.115-11.679,P<0.05)was more likely to form liver fire syndrome.The ?/? genotype syndrome was more than that of other syndrome types,and the difference was statistically significant(p<0.05).Regression analysis showed that ?/? type(RR=3.339,95%CI:1.732-6.479,P<0.05),I/D type(RRF=2.342,95%CI:1.165-4.283,P<0.05)are more inclined to form Profuse expectoration and retention of dampness syndrome.4?The CYP2D6 genotype CC type has more syndromes than yin and yang syndromes,and the difference is statistically significant(p<0.05).Regression analysis shows CC genotype(RR=1.986,95%CI:1.050-3.793,P<0.05)is more inclined to form yin and yang deficiency type.The syndrome differentiation of TT type was more than that of other syndrome types,and the difference was statistically significant.Regression analysis showed that TT type(RR=2.145,95%CI:1.105-4.165,P<0.05)was more inclined to form Profuse expectoration and retention of dampness syndrome.5?The genotypes and allelic distributions of AGTR1,ADRB1,and CYP2C9 have nothing to do with TCM syndrome types.Conclusion1?In this study,the average age of patients with yin and yang deficiency was the highest,and those with longer duration of disease were mostly,revealing that yin and yang deficiency may be the final outcome of hypertension;smoking history and family history may affect the distribution of syndromes.2?ACE I/D,genes are associated with the development of hypertension and affect the patient's diastolic pressure3?ACE gene DD type may be related to the liver fire syndrome of people with EH,and type ? may be associated with Profuse expectoration and retention of dampness syndrome.4?CYP2D6 TT genotype may be associated with EH type of Profuse expectoration and retention of dampness;and CC genotype may be associated with yin and yang deficiency type. |
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