Analysis Of TCM Syndromes Of Hypertension Complicated With Atrialarrhythmia Based On His "Real World"

Objective:Based on HIS "Real World",we collected the patients with hypertension complicated with atrial arrhythmia,analyzed and discussed the syndrome factors,the target of syndrome factors,the characteristics and distribution of TCM syndromes,besides established the diagnostic model of common syndromes,which laid the foundation for the establishment of mature TCM diagnostic criteria for hypertension patients with atrial arrhythmia.Methods:The data of hospitalized patients who met the inclusion criteria from January 1,2017 to December 31,2019 were extracted from the His system of the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine,finally,316 cases were included according to the general rules of multivariate analysis.With The information of four diagnoses of TCM was collected,the rules were obtained by frequency analysis,factor analysis and cluster analysis,and the diagnosis model of common TCM syndromes was established by using two-classification Logistic regression analysis.Results:1.A total of 316 patients were involved in this study,including 160males(50.63%)and 156 females(49.37%).The patients with smoking history accounted for 55.70% of all patients,and the patients with the course of hypertension between 10 and 20 years accounted for 51.90%.The second was patients with a course of more than 20 years,accounting for 25.00%.2.The top 5 symptoms and signs were vertigo(83.20%),chest tightness(60.40%),palpitation(48.10%),dry mouth(24.40%)and frequent nocturnal urination(23.40%).The three most common tongue images are fat tongue(42.70%),greasy fur(39.90%),lilac or purple dark tongue(37.00%),sunken pulse(33.00%)is the most common,followed by string pulse(14.20%).3.Eight syndrome factors were extracted based on factor analysis,of which 5 were solid elements,including turbid phlegm,blood stasis,internal heat,qi stagnation and water dampness.There are three deficiency elements,which are qi deficiency,yang deficiency and yin deficiency.There are 7targets of syndrome elements,including heart,spleen,liver,lung,stomach,collaterals and kidney.The three main syndrome factors are internal heat(18.28%),turbid phlegm(16.43%)and yin deficiency(14.58%).The targets of the three main syndrome factors were heart(28.38%),spleen(19.96%)and liver(18.18%).4.Based on cluster analysis,TCM syndromes can be divided into five types: qi stagnation and blood stasis syndrome,yin deficiency and yang hyperactivity syndrome,phlegm-dampness syndrome,kidney-yang deficiency syndrome and heart-spleen deficiency syndrome.5.Results of diagnostic model of qi stagnation and blood stasis syndrome and hyperactivity of yin and yang syndrome: the area under the ROC curve was 0.865 and 0.982,the sensitivity corresponding to the maximum critical value of Youden index was 80.6% and 93.6%,and the specificity was 86.5% and 92.4%.Conclusion:1.The syndrome factors of hypertension complicated with atrial arrhythmia are deficiency and excess,yin deficiency is mostly in deficiency factors,heat,phlegm and blood stasis are the most common in solid syndrome,the main syndrome target is heart,followed by spleen.2.Patients with hypertension complicated with atrial arrhythmia can refer to the following TCM types: qi stagnation and blood stasis,yin deficiency and yang hyperactivity,accumulation of phlegm and dampness,deficiency of kidney yang,deficiency of both heart and spleen.Among the syndrome types,the variance contribution rate of qi stagnation and blood stasis syndrome was the highest,followed by yin deficiency and yang hyperactivity syndrome.3.The diagnostic models of qi stagnation and blood stasis syndrome and yin deficiency and yang hyperactivity syndrome fit well,which have high sensitivity and specificity,and its clinical diagnostic value needs further study.