Study On The Distribution Law Of TCM Syndrome Types Of Middle-aged And Young People With Essential Hypertension And Its Correlation With Objective Indexes

Research purposes: To explore the distribution characteristics of TCM syndrome types in young and middle-aged patients with hypertension,and to analyze the correlation between TCM syndrome types and blood lipid levels,fasting blood glucose,blood uric acid,glomerular filtration rate,carotid intima-media thickness and other indicators,so as to provide objective reference basis for TCM syndrome differentiation.Methods: Clinical patients aged 18-64 years who met the inclusion criteria were collected from the cardiovascular outpatient department and wards of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from September 2020 to February 2021.According to the diagnostic criteria of TCM syndromes in this study,TCM syndromes were differentiated and classified.Using the method of investigation and research,the data of the four TCM diagnoses of the patients were collected in the form of questionnaire,and the general information of the patients,such as blood pressure,personal history,as well as the indexes such as blood lipid level,fasting blood glucose,blood uric acid,glomerular filtration rate,carotid intima-media thickness were collected.The database was established and SPSS25.0 was used for statistical analysis.Results1 The distribution of TCM syndrome types of hypertension in the young and middle-aged people: Phlegm dampness type > hyperactivity of liver fire type > Yin deficiency and Yang hyperactive type > Kidney Qi deficiency type > Blood stasis block type.2 The age comparison among different TCM syndromes of middle-aged and young people with hypertension showed that the age of hyperactive liver fire type was significantly lower than that of hyperactive Yin deficiency and Yang type(P < 0.01).3 There was significant statistical difference in the age stratified distribution of different genders(P < 0.01).Hypertension is more common in men than in women before the age of 50 and after that in women.4 The number of people with hypertension grade 3 is the largest,grade 2 is the second,and grade 1 is the least.The TCM syndromes of hypertension patients at all levels are mainly liver-fire hyperactivity and phlegm-dampness syndrome.The diastolic blood pressure and family diastolic blood pressure in the office of the hyperactive liver-fire type group were significantly higher than those of the yin deficiency and yang hyperactivity group,both P <0.01.5 There were 61 cases of middle-aged and young men with a history of smoking,accounting for 92.4% of the total number of smokers,only 5 cases of women with a history of smoking,accounting for 7.6% of the total number of smokers;84 cases of men with a history of drinking,accounting for the total number of drinking 97.7%,there were only 2 females with a history of drinking,accounting for 2.3% of the total number of drinking.The number of males smoking and drinking was significantly more than females,both P<0.01.6 The BMI classification of young and middle-aged hypertension patients is mostly overweight and obesity.There are 174 cases of the two,accounting for 76.3% of the total number of cases.There are statistically significant differences in the BMI grading and distribution of different TCM syndrome types(P<0.05).The proportion of patients in the phlegm-dampness type BMI super-recombination and BMI obesity group was higher than that of the normal BMI group,both P<0.05.The difference of average waist circumference among different TCM syndromes was statistically significant(P<0.05).The average waist circumference of young and middle-aged hypertensive patients with phlegm-dampness type was larger than that of kidney-qi deficiency type and yin-deficiency yang hyperactivity type,both P<0.05.7 The distribution of TC,TG,HDL-C,LDL-C,FPG,UA,and e GFR among the various TCM syndrome types in young and middle-aged hypertensive patients was not statistically significant(P<0.05).8 The majority of carotid IMT in young and middle-aged hypertensive patients is thickened,with 145 cases,accounting for 63.3% of the total.The TCM syndromes of the thickened carotid IMT group are mainly phlegm-dampness type,followed by hyperactive liver-fire.The distribution of the thickened carotid IMT in different TCM syndrome types is statistically different(P < 0.05).9 In this study,there was a statistical correlation between hyper irascibility and age.The possibility of hyper irascibility with syndrome differentiation in young and middle-aged patients with hypertension decreased by 0.949 times for every 1 year increase in age.There was a statistical correlation between excessive phlegm-dampness type and BMI.For every1kg/m2 increase in BMI in middle-aged and young hypertension patients,the possibility of excessive phlegm-dampness type with syndrome differentiation was increased by 1.101 times.Conlusion1 The distribution of TCM syndrome types of middle-aged and young people with hypertension has a certain regularity: Phlegm dampness type > hyperactivity of liver fire type >Yin deficiency and Yang hyperactive type > Kidney Qi deficiency type > Blood stasis block type.2 There are differences in age among different TCM syndromes.The age of hyperactive liver-fire is significantly lower than that of yin-deficiency and yang-hyperactivity.It is suggested that with the growth of age,the pathogenesis of hypertension changes from sthenic sydrome to mixture of asthenia and sthenia.3 In this study,there are differences in the age of onset of hypertension in different genders.Before the age of 50,there are more men with hypertension than women,and after the age of50,there are more women with hypertension than men.It suggests that after the age of 50,the gap in the incidence of hypertension between men and women has narrowed.4 The TCM syndromes of young and middle-aged hypertensive patients with BMI graded as overweight or obesity are mostly phlegm and dampness.BMI has certain reference value for the diagnosis of phlegm-dampness in middle-aged and young patients with hypertension.With the increase of BMI,the possibility of syndrome differentiation of phlegm-dampness is relatively higher.5 The TCM syndromes of middle-aged and young people with hypertension and carotid IMT thickened are more common types of phlegm-dampness and hyperactive liver fire.