Correlation Between TCM Syndrome Types And Serum Lipid Indexes In Elderly Hypertension

1 ObjectiveThis topic collects the information of the four diagnosis of elderly hypertensive patients,analyzes the distribution pattern of TCM syndromes of hypertension in elderly patients,conducts a correlation study between the distribution of TCM syndromes and blood lipid indexes in elderly hypertensive patients,and summarizes the effect of blood lipid index on the distribution of elderly hypertension syndrome.2 Research methodsScreening of inpatients in the Affiliated Hospital of Tianjin Academy of Traditional Chinese Medicine from October 2017 to January 2020,we selected 157 subjects who met the inclusion criteria for elderly hypertension.Referring to the "Guidelines for Clinical Research on New Drugs of Traditional Chinese Medicine"(2002 edition)and "Guidelines for Diagnosis and Treatment of Common Diseases in Traditional Chinese Medicine"(2008 edition),we combined with the information of the four clinics,to carry out syndrome differentiation and classification.General records of patients include: gender,age,hospitalization number,medical record number,smoking history,drinking history;past history includes: coronary heart disease history,diabetes history,cerebral infarction,dyslipidemia;auxiliary tests include: triglycerides(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),D-dimer(DD),fasting blood glucose(FPG),cervical vascular color ultrasound,cardiac color ultrasound,etc.and the conventional indexes of blood lipid were used to calculate the plasma-induced arteriosclerosis index(AIP)and arteriosclerosis index(AI).Finally,statistical software SPSS25.0 was used for data analysis.3 Research results 3.1 Comparison of TCM Syndrome Distribution and General Indexes in Elderly Hypertension 3.1.1 Distribution of TCM Syndrome TypesAmong the 157 elderly hypertensive cases included,the phlegm and blood stasis syndrome accounted for the largest proportion,followed by yin and yang deficiency syndromes,and the yin deficiency and yang hyperactivity syndromes and liver fire hyperactivity syndromes accounted for the least.Its composition ratio: 74 cases(47.13%)of stagnation of phlegm and stasis,35 cases(22.29%)of deficiency of yin and yang,27 cases(17.2%)of deficiency of yin and yang,and 21 cases(13.38%)of hyperactivity of liver and fire.3.1.2 Comparison of baseline conditions among TCM syndromesIn the included cases,the age comparison results among the different types of syndromes showed that: the deficiency of yin and yang syndrome> stagnation of phlegm and stasis syndrome and the syndrome of hyperactivity of liver and fire,the difference was statistically significant.In the included cases,the hypertension classification among different syndrome types was compared,and the results showed that the differences were statistically significant.Most of the patients with phlegm-stasis syndrome and liver-fire hyperactivity syndrome are classified with hypertension grades 2 and 3,and the proportion of patients with yin deficiency and yang hyperactivity syndrome and yin and yang deficiency syndrome with hypertension level 1 is higher than that of the other two types of syndromes.In the included cases,the risk factors among different syndrome types were compared,and the results showed that the elderly with hypertension and previous history of drinking had significantly higher yin and yang deficiency than other syndromes,and the difference was statistically significant.There were no significant differences among the syndromes in terms of gender,smoking history,and previous medical history.3.1.3 Comparison of Examination Indexes among TCM SyndromesThe blood lipid and blood lipid comprehensive index levels among different syndrome types were compared.The results showed that at the level of HDL-C,the syndrome of deficiency of both yin and yang and the syndrome of phlegm and stasis were lower than that of hyperactivity of yin and deficiency,and the difference was statistically significant.There is no significant difference in the levels of TG,TC,LDL-C,AIP,and AI of each syndrome type.Compared with the levels of D-dimer among different syndrome types,the syndromes of deficiency of both yin and yang and stagnation of phlegm and blood stasis are higher than those of deficiency of yin and yang and the difference is statistically significant.There is no significant difference in other syndrome types.No significant difference in fasting blood glucose among the groups.3.1.4 Comparison of carotid stenosis and left atrial enlargement among different types of syndromesIn the included cases,the detection rate of carotid plaques of each syndrome was above 90%.The highest detection rate of carotid arterial stenosis with liver fire syndrome is 42.86%.The maximum detection rate of left atrium enlargement of yin and yang deficiency is 57.14%.3.2 Comparison of general indexes among different blood pressure classes in elderly hypertensive patientsThe data analysis results of elderly hypertensive patients show that: Hypertension has the most grade 3 distribution in elderly hypertensive patients.In the gender distribution,the proportion of men with hypertension level 2 is higher than that of women,and the proportion of women with hypertension level 3 is significantly higher than men,and the difference is statistically significant.The differences in AIP and AI levels of different hypertension grades are statistically significant.After the correlation test,the hypertension grades are positively correlated with AIP and AI,and the hypertension grades increase as the AIP and AI levels increase.Different grades of hypertension were not significantly associated with smoking history,drinking history,carotid stenosis,and left atrial enlargement.4 ConclusionElderly patients with hypertension have the most frequent sputum and stasis syndromes,followed by yin and yang deficiency syndromes,indicating that the pathological mechanism is mainly based on deficiency,sputum and stasis,which is closely related to liver,spleen and kidney deficiency and yin and yang disorders.Elderly patients with hypertension have the highest number of grade 3 hypertension,of which the blood pressure classification of patients with phlegm and stasis syndrome and hyperactivity of liver fire is concentrated in grades 2 and 3 of hypertension.Elderly hypertensive patients are often accompanied by dyslipidemia,in which the HDLC level of yin-yang deficiency syndrome and sputum stasis syndrome is lower than that of yinyang deficiency syndrome.The grade of hypertension in patients increased significantly with the increase of AIP and AI levels,indicating that dyslipidemia is closely related to the occurrence of hypertension in the elderly and the two interact with each other,providing data support for the comprehensive index of blood lipids as a risk factor for senile hypertension.