| Objective:To explore the pathogenic syndrome elements,syndrome type distribution law and the correlation between syndrome type and clinical indicators of H-type hypertension,and combine traditional Chinese medicine with modern western medicine,and make an objective and systematic evaluation.To enrich the clinical understanding of H-type hypertension,and provide the basis for the prevention and treatment of H-type hypertension by traditional Chinese medicine,and explore new ideas.Methods:By Formulating the "observation table of TCM clinical syndromes of H-type hypertension",collected the basic information,syndromes and laboratory indicators of 300 patients with H-type hypertension who met the inclusion criteria and screened by the exclusion criteria,then identified the syndrome elements by using Syndrome Differentiation of Syndromes,then formed the syndrome elements into syndrome types,and then used SPSS 26.0 to obtain the distribution of TCM syndrome elements and syndrome types of H-type hypertension,and explored the correlation between syndrome types and clinical data.Results : 1.The distribution of pathogenic syndrome elements in 300 patients with H-type hypertension included in this study was: Blood Stasis(55.3%)、 phlegm turbidity(50.7%)、Yin deficiency(44.3%)、Qi deficiency(39.7%)、 Yang Hyperactivity(34.7%)、 blood deficiency(21.7%)、 Yang deficiency(8%)、 Dampness(6.7%)、 Fire(heat)(4.7%).2.There were seven types of H-type hypertension syndrome obtained in this study,covering 264 patients.Their distribution was as follows: phlegm and blood stasis syndrome(28.7%)、 Yin deficiency and yang hyperactivity syndrome(15.7%)、 Qi deficiency and blood stasis syndrome(11.7%)、 liver yang hyperactivity syndrome(10.3%)、 Qi and yin deficiency syndrome(9%)、Qi and blood deficiency syndrome(8.3%)、 Yin and yang deficiency syndrome(4.3%).The average age was 70.56 ± 12.99 years old,185 males and 79 females.There were significant differences in gender between different syndrome types(P < 0.05),among which women were the majority of Qi and blood deficiency syndrome.3.There were significant differences in age and course of disease among different syndrome types.There were significant differences between liver yang hyperactivity syndrome and yin deficiency yang hyperactivity syndrome and phlegm and blood stasis syndrome,Qi and yin deficiency syndrome,Qi and blood deficiency syndrome and Yin and yang deficiency syndrome,respectively(P < 0.05).The patients with deficiency of yin and yang were the oldest and had the longest course of disease,while the patients with hyperactivity of liver yang were the youngest and have the shortest course of disease.4.There was no significant difference in systolic and diastolic blood pressure among syndrome types(P > 0.05).5.The comparison of laboratory indexes among the syndrome types was as follows:(1)among the syndrome types,the level of Hcy in phlegm and blood stasis syndrome was the highest,followed by qi deficiency and blood stasis syndrome.Phlegm and blood stasis syndrome and Qi deficiency and blood stasis syndrome were significantly different from Yin deficiency and yang hyperactivity syndrome,liver yang hyperactivity syndrome,Qi and yin deficiency syndrome and Qi and blood deficiency syndrome,respectively(P <0.05).(2)The UA level of hyperactivity of liver Yang was the highest among the syndrome types,followed by deficiency of Qi and Yin and phlegm and blood stasis.Among them,there was significant difference between liver yang hyperactivity syndrome and yin deficiency yang hyperactivity syndrome,Qi deficiency and blood stasis syndrome,Qi and blood deficiency syndrome and Yin and yang deficiency syndrome(P < 0.05);Qi and yin deficiency syndrome and phlegm and blood stasis syndrome were statistically significant compared with Qi deficiency and blood stasis syndrome,yin and yang deficiency syndrome and Qi and blood deficiency syndrome respectively(P < 0.05).(3)Among all syndrome types,the level of SCR in phlegm and blood stasis syndrome was the highest,followed by qi deficiency and blood stasis syndrome.There was significant difference between Qi and blood deficiency syndrome and Qi deficiency and blood stasis syndrome and phlegm and blood stasis syndrome(P< 0.05).(4)There was no significant difference in blood glucose and blood lipid among syndrome types(P > 0.05).6.The level of Hcy in elderly patients was higher than that in middle-aged patients(P < 0.05);The level of Hcy in smoking and drinking patients was higher than that in non-smoking and drinking patients(P < 0.05);There was no significant difference in Hcy level between different genders(P > 0.05).7.The level of Hcy was positively correlated with the classification of hypertension,cardiovascular risk stratification of hypertension,course of disease and SCR level(r > 0,P < 0.05),but not with blood glucose,blood lipid and UA(P > 0.05).Conclusion:The incidence of H-type hypertension includes five important links: blood stasis,phlegm turbidity,yin deficiency,Qi deficiency and yang hyperactivity.The top four syndrome types are phlegm and blood stasis syndrome,yin deficiency and yang hyperactivity syndrome,Qi deficiency and blood stasis syndrome and liver yang hyperactivity syndrome.The high incidence of this disease is the elderly,and most of them are men,but the syndrome of Qi and blood deficiency is more common in female patients,and the syndrome of hyperactivity of liver Yang is more common in middle-aged patients.The patients with deficiency of yin and yang are the oldest and have the longest course of disease;The patients with hyperactivity of liver Yang have the youngest age and the shortest course of disease.Hcy level can be used as the syndrome differentiation reference of phlegm and blood stasis syndrome,Qi deficiency and blood stasis syndrome,UA level can be used as the syndrome differentiation reference of liver yang hyperactivity syndrome,Qi Yin deficiency syndrome and phlegm and blood stasis syndrome,and SCR level can be used as the syndrome differentiation reference of phlegm and blood stasis syndrome,Qi deficiency and blood stasis syndrome.Elderly,smoking,drinking and other factors will increase the level of Hcy,and the level of Hcy will increase with the level of hypertension,cardiovascular risk stratification of hypertension,course of disease and SCR level. |
