Correlated Comparison Between Clinical Factors Of The Exuberance Of Phlegm-damp And The Yin Deficiency Yang Hyperactivit In Patients Of Resistant Hypertension

Objective:The Exuberance of Phlegm-damp and the Yin Deficiency Yang Hyperactivit are the two most common syndromes of traditional Chinese medicine(TCM)with resistant hypertension(RH).To explore the distribution of RH two syndrome types and clinical common objective factors such as blood test indicators,cardiac ultrasound,ambulatory blood pressure,target organ damage.The purpose is to provide a reference for clinical objective indicators for RH two syndrome types.Methods:This study included 150 patients with RH who met the criteria for inclusion of Chinese and Western medicine in the cardiology department of Hospital affiliated to Shanghai University of Traditional Chinese Medicine from June 2018 to February 2019.Improve related blood tests,cardiac ultrasound,24-hour ambulatory blood pressure were check.With reference to the "Guidelines for the Use of Clinical Research Guidelines for New Drugs in Traditional Chinese Medicine" and the actual situation in clinical syndrome differentiation,at lease two Chinese medicine practitioners the level of treatment will be used for syndrome differentiation.SPSS22.0 was used for statistical analysis of data.Results:(1)There were differences in age distribution between the two types of RH(?2=51.153,P<0.001),the Exuberance of Phlegm-damp is mainly under the age of 70,and the Yin Deficiency Yang Hyperactivit is the main type above 70 years old.There was no significant difference in gender distribution between males and females(P>0.05).There was differences in hypertensive course between the two types(P<0.001),with The Exuberance of Phlegm-damp(14.01±7.11)years and the Yin Deficiency Yang Hyperactivit(18.78±8.87)years.And he Yin Deficiency Yang Hyperactivit has longer hypertensive course.There was no significant difference in TCM symptom score(P>0.05),with The Exuberance ofPhlegm-damp(10.14±2.92)points and the Yin Deficiency Yang Hyperactivit(10.91±2.91)points.(2)There were differences in the comparison of triglycerides(P<0.05),with The Exuberance of Phlegm-damp(2.11±0.67)mmol/L and the Yin Deficiency Yang Hyperactivit(1.77±1.29)mmol/L.And there were no statistical significance between cholesterol with(4.82±0.94)mmol/L VS(4.62±1.07)mmol/L,high-density lipoprotein with(1.19±0.28)mmol/L VS(1.16±0.27)mmol/L and low-density lipoprotein with(3.15±0.75)mmol/L VS(2.98±0.79)mmol/L(P>0.05).There were different in urea nitrogen with(6.37±1.61)mmol/L VS(7.69±2.64)mmol/L and Estimated Glomerular Filtration Rate(e GFR)with(86.95±17.42)ml/min/1.73m2VS(77.36 ± 23.27)ml/min/1.73m2(P<0.01).The Yin Deficiency Yang Hyperactivit have higher urea nitrogen and lower e GFR.There was no significance in uric acid comparison(P>0.05).There were no statistically significant difference in alanine aminotransferase with(21.0)U/L VS(21.5)U/L,aspartate aminotransferase with(18)U/L VS(20)U/L,fasting blood glucose with(5.5)mmol/L VS(5.4)mmol/L,hemoglobin A1 c with(6.1)% VS(6.0)%,hemoglobin with(139.7±16.1)g/L VS(136.2±13.8)g/L,DD dimer with(0.27±0.28)mg/L VS(0.34±0.25)mg/L,troponin with(0.015±0.011)ng/m L VS(0.025±0.016)ng/m L,Brain Natriuretic Peptide(BNP)with(42.04±37.42)pg/m L VS(51.23±43.09)pg/m L of RH two syndromes(P>0.05).(3)There was different in the interventricular septum thickness with(12.0)mm VS(11.0)mm between the two types of RH(P<0.05),and the Exuberance of Phlegm-damp was larger.There were no significant difference in the left atrial diameter with(42.0)mm VS(40.5)mm,left ventricular end-diastolic diameter with(29.0)mm VS(29.0)mm,left ventricular end-diastolic diameter(48.0)mm VS(47.0)mm,left ventricular posterior wall thickness with(11.5)mm VS(11.0)mm,and left ventricular ejection fraction with(62.0)% VS(61.5)%(p>0.05).(4)There were statistical differences between the average systolic blood pressure of the white sputum with(151.0)mm Hg VS(161.0)mm Hg,the variability of the 24-hour systolic pressure with(11.96)% VS(13.27)% in the two syndromes(P<0.05).There were no significant differences in the 24 hour average systolic blood pressure with(148.5)mm Hg VS(153.0)mm Hg,the 24 hour average diastolic blood pressure with(85.0)mm Hg VS(83.0)mm Hg,the average white diastolic blood pressure with(88.5)mm Hg VS(87.0)mm Hg,the average nighttime systolic blood pressure with(138.0)mm Hg VS(133.5)mm Hg,the average nighttime diastolic blood pressure with(77.0)mm Hg VS(74.0)mm Hg,24-hour diastolic blood pressure variability with(13.37)% VS(14.20)%,white systolic blood pressure variability with(11.47)%VS(12.80)%,white diastolic blood pressure variability with(12.84)% VS(13.48)%,nighttime systolic blood pressure variability with(10.39)% VS(10.86)%,and nighttime diastolic blood pressure variability with(12.21)% VS(12.18)%(P>0.05).(5)There was a significant difference in the distribution of circadian Rhythm of blood pressure between the two syndromes of RH(?2=14.585,P<0.001).The Exuberance of Phlegm-damp is mainly non-spoon type,and the Yin Deficiency Yang Hyperactivit is mainly scoop type.(6)There were different in the target organ damage(P<0.05),with heart damage with [61(70.93%)] VS [35(54.69%)],braindamage with [25(29.07%)] VS [42(65.63%)],kidny damage with [5(5.81%)] VS[14(21.88%)].And the Exuberance of Phlegm-damp is mainly in heart,the Yin Deficiency Yang Hyperactivit is mainly in brain and kidney.There was no different in arterial injury with [67(77.90%)] VS [45(70.31%)](P>0.05).Conclusions:There were different in the age,hypertensive course,triglycerides,urea nitrogen,e GFR,interventricular septum thickness,the average systolic blood pressure of the white sputum,the variability of the 24-hour systolic pressure,circadian Rhythm of blood pressure,target organ damage of RH two syndrome types.This can be used as a dialectical reference for the Exuberance of Phlegm-damp and the Yin Deficiency Yang Hyperactivit of RH.