Study On The Correlation Between Common Syndromes,Classification And Risk Stratification Of Senile Hypertension

Objective : Combining the syndrome differentiation of TCM with the standard of modern medical evolvement,by studying the correlation between TCM syndromes,classification and risk stratification of senile hypertension,the distribution and evolution of syndrome types of senile hypertension were analyzed,and the differences of cardiovascular risk factors and clinical conditions were discussed in order to provide an objective argument for the treatment of hypertension with the combination of TCM and Western medicine.Methods:The objects of study came from 260 patients who were diganosed essential hypertension in Geriatrics Department of Yunnan Traditional Chinese Medicine Hospital from January to March in 2019.The clinical information of the patients was collected and their blood pressure grading and risk grading were evaluated.By the standard of the Guiding Principles for Clinical Research of New Chinese Medicine(Trial Implementation),2002 edition,and the TCM Diagnosis and Treatment Program and Clinical Path of Geriatrics Department of Yunnan Traditional Chinese Medicine Hospital in 2017,TCM syndrome differentiation and typing were carried out,which were divided into Qi deficiency and blood stasis syndrome,hyperactivity of liver-yang syndrome,deficiency of kidney-yin syndrome and obstruction of Phlegm-turbidity syndrome.IBM SPSS24.0 Stastistic was used to analyze the data stastistically.Results : This study included 260 elderly patients with hypertension,147 males(56.5%)and 113 females(43.5%).Among 260 patients,30(11.5%)had grade 1hypertension,81(31.2%)had grade 2 hypertension and 149(57.3%)had grade 3hypertension.Among them,there were 7 cases(2.7%)in low-risk group,18 cases(6.9%)in medium-risk group,69 cases(26.5%)in high-risk group and 166 cases(63.9%)in high-risk group.1?The distribution of TCM syndromes index from high to low in male patients is index from high to low in male patients is:hyperactivity of liver-yang > obstruction of phlegm and turbidity > Qi deficiency and blood stasis > deficiency of kidney-yin;the distribution of TCM syndromes in female patients from high to low is: deficiency of kidney-yin > deficiency of Qi and blood stasis > obstruction of phlegm >hyperactivity of liver-yang.The proportion of phlegm stagnation syndrome,liver-yang hyperactivity syndrome,Qi deficiency and blood stasis syndrome in male was higher than that in female,and the proportion of kidney-yin deficiency syndrome in females was higher than that in male.2?The systolic blood pressure level of hyperactivity of liver-yang syndrome in elderly patients with hypertension is the highest,and the blood pressure grading is the highest.The risk stratification of phlegm turbidity obstruction syndrome is the highest,the average age of phlegm turbidity obstruction syndrome patients is the highest,and the history of disease is the longest.The change of age and history of hypertension from low to high suggests the trend of the change of syndrome types of hypertension.Qi deficiency and blood stasis syndrome combined with heart disease and retinopathy has the highest risk.The kidney yin deficiency syndrome with kidney disease and diabetes mellitus has the highest risk.The risk of phlegm stagnation syndrome combined with peripheral vascular disease is the highest.There is a significant correlation between the classification of senile hypertension,risk stratification and the classification of TCM syndromes.3?There were significant differences in age and course of disease among different syndromes(P < 0.001).The order of age and history of each syndrome type from high to low is phlegm stagnation syndrome > Qi deficiency and blood stasis syndrome >kidney yin deficiency syndrome > liver yang hyperactivity syndrome.The hyperactivity of liver Yang group was lower than the other three groups.The change of age and history of hypertension from low to high suggests the trend of the change of syndrome types of hypertension.4?The high-risk group of senile hypertension accounted for the highest proportion of the four syndrome types.Cardiovascular risk stratification from high to low was phlegm stagnation syndrome,liver-yang hyperactivity syndrome,Qi deficiency and blood stasis syndrome,kidney-yin deficiency syndrome,the difference was statistically significant(P < 0.001).5?There were statistical differences in TC and LDL-C of different syndromes(P <0.05),but there was no statistical difference in HDL-C(P > 0.05).The results of LSD showed that TC value of phlegm stagnation syndrome was higher than the TC values with Qi deficiency and blood stasis syndrome and kidney yin deficiency syndrome.The LDL-C value of Phlegm-turbidity obstruction syndrome was higher than theLDL-C value with kidney-yin deficiency syndrome and liver-yang hyperactivity syndrome,while that of qi deficiency and blood stasis syndrome was higher than that of liver-yang hyperactivity syndrome.There were statistical differences among different types of abdominal obesity(P=0.004),and the incidence of Phlegm-turbidity obstruction syndrome was the highest.There was no statistical difference in smoking history among different syndromes(P=0.059).There was no significant difference in family history of early cardiovascular disease among different syndrome types(P <0.05).There was no statistical difference in homocysteine among different syndromes(P > 0.05).6 ? There was no statistical difference in the incidence of cerebrovascular disease among different syndromes(P > 0.05).There were significant differences in the incidence of heart disease among different syndromes(P < 0.05).Qi deficiency and blood stasis syndrome > kidney yin deficiency syndrome > phlegm turbidity obstruction syndrome > liver yang hyperactivity syndrome.There were significant differences in the incidence of kidney diseases among different syndromes(P=0.012).Kidney Yin deficiency syndrome > phlegm turbidity obstruction syndrome > Qi deficiency and blood stasis syndrome > liver yang hyperactivity syndrome.The incidence of peripheral vascular disease in different syndrome types was significantly different(P=0.001),Phlegm-turbidity obstruction syndrome(51.7)> kidney-yin deficiency syndrome = Qi deficiency and blood stasis syndrome > liver-yanghyperactivity syndrome.The incidence of retinopathy of different syndromes was significantly different(P=0.008).Qi deficiency and blood stasis syndrome > phlegm turbidity obstruction syndrome > liver yang hyperactivity syndrome > kidney yin deficiency syndrome.The incidence of diabetes mellitus in different syndromes was significantly different(P=0.001).Among them,kidney yin deficiency syndrome >phlegm turbidity obstruction syndrome > Qi deficiency and blood stasis syndrome >liver yang hyperactivity syndrome.CONCLUSION: The systolic blood pressure level of hyperactivity of liver-yang syndrome in elderly patients with hypertension is the highest,and the blood pressure grading is the highest.The risk stratification of phlegm turbidity obstruction syndrome is the highest,the average age of phlegm turbidity obstruction syndrome patients is the highest,and the history of disease is the longest.The cholesterol value of Phlegm-turbidity obstruction syndrome was the highest,and the LDL value of Qi-deficiency and blood-stasis syndrome and Phlegm-turbidity obstruction syndrome was higher than that of other two groups.The proportion of abdominal obesity with obstruction of liver phlegm is the highest.Qi deficiency and blood stasis syndrome combined with heart disease and retinopathy has the highest risk.The kidney yin deficiency syndrome with kidney disease and diabetes mellitus has the highest risk.The risk of phlegm stagnation syndrome combined with peripheral vascular disease is the highest.There is a significant correlation between the classification of senile hypertension,risk stratification and the classification of TCM syndromes.