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The Relations of Deficiency and Excessive Syndrome of TCM and Ultrasonic Cardiogram and P Wave Terminal Force in Lead 1 for the Patients with Hypertension

Author: HanJie
Tutor: JinZhuoXiang
School: Guangzhou University of Traditional Chinese Medicine
Course: Chinese medical science
Keywords: hypertension P wave terminal force in lead 1 (PtfV1) ultrasonic cardiogram (UCG) deficiency syndrome and excessive syndrome of TCM
CLC: R544.1
Type: Master's thesis
Year: 2011
Downloads: 20
Quote: 0
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Abstract


BackgroundEssential Hypertension was defined as a syndrome that the main clinic expression was elevation of blood pressure. At 2005, American association of hypertension gave a new definition about it:hypertension was a cardiovascular syndrome in evolutional state which was caused by a lot of reasons. It could reduce changes in function and structure of heart and artery. This new definition pointed out that:not only the numbers of blood pressure, but also the coalition of the numbers of blood pressure、risk factors、early marks of disease and injuries of target organ would express exceptional pathological changes in cardiovascular and other organs reduced by hypertension well and truly.ObjectivesElectrocardiogram was a main detection mean to diagnose hypertensive heart disease in clinic. The heart injury of Essential Hypertension would express in Left arterial enlargement and left ventricular hypertrophy. According the data, the incidence rate of Left arterial enlargement was higher than the left ventricular hypertrophy’s. P wave terminal force in lead 1(PtfV1) was the area of depolarizing force of left heart. As the number of the PtfVl elevated, left arterial conduction block and left ventricular contractile function would be get worse. PtfVl may be one of indexes to evaluate the functions of heart at phase of relaxation and left ventricular dysfunction. At present, there are many scholars and professors pointing out the relationships between PtfVl and TCM syndromes of hypertension. We can use ECG to analyze TCM syndromes, and initially to show the relationships between PtfVl and TCM syndromes of hypertension. It may be give some proves to clinic dialectic treatments and scientific researches.E/A was one of the main indexes to reflect left ventricular contractile function. It has been proved that left ventricle diastolic dysfunction would earlier appear than cardiac contractile dysfunction. Cardiac diastolic hypo function will finally reduce the enlargement of left atrium and left auricular enlargement will finally change the structure of heart. Two-dimensional ultrasonic diagnosis and Doppler ultrasonic diagnosis helped to checkout early period damage of left atrium and evaluated the degree of damage. We will choose 5 indexes, including interventricular septal thickness(IVST)、left ventricular posterior wall thickness (LVPW)、E/A、left ventricular end-diastolic diameter (LVDED)、Left ventricular ejection fraction(LAEF), to analysis and to enhance the relationship between ECG and TCM syndromes of deficiency syndrome group and excessive syndrome group.MethodsCases collected between 2005.1-2010.12 from Guangdong provincial hospital of TCM 200 hypertensive patients, whose have accepted ECG and ultrasonic cardiogram (UCG) examinations. According to the TCM syndrome differentiation, we will divided two groups including deficiency syndrome group and excessive syndrome group, and we also divided three different groups according to the dates of PtfV1. we hope to find the relationship between different groups of hypertensive patients and different groups of PtfV1, and want to find the relationship between different degree hypertensive patients、different risk factors of hypertensive patients and PtfVl. we also want to find out the relationship between 5 indexes of UCG and different degree of PtfVl.ResultThe results showed that the patients with hypertension of deficiency syndrome and excessive syndrome of TCM had not statistically significant differences in distinguishing between the sexes、ages、different grades and risk stratification of hypertension and P wave terminal force in lead 1 (PtfVl) of ECG. But there are some statistically significant differences in different grades of hypertension and different groups of P wave terminal force in lead 1(PtfV1) of ECG(P<0.05).ConclusionThe patients with hypertension of deficiency syndrome and excessive syndrome of TCM had not statistically significant differences in distinguishing between P wave terminal force in lead 1(PtfV1) of ECG and UCG. But there are some statistically significant differences in different grades of hypertension and different groups of P wave terminal force in lead 1 (PtfV1) of ECG(P<0.05). It points out that:as the development of hypertension, the changes of heart will be larger and larger in structures and functions.

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CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Abnormal blood pressure > Hypertension
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