The Relationship Between The Smoothness Index Of Ambulatory Blood Pressure And TCM Differentiation In Elderly Hypertension Patients

Objective:To investigate the relationship between the smoothness index(SI) of ambulatory blood pressure and traditional Chinese medicine (TCM) differentiation in elderly hypertension patients, and provide a basis for objective type of syndrome in elderly hypertensive disease to guide clinical treatment.Methods:According to "China Hypertension Prevention Guide" 2010 diagnostic criteria, selected from January 2010 to December 2012, Nanjing Municipal Hospital of TCM, the hospitalization history data of 200 elderly essential hypertension patients were analyzed, filled in the registration form of clinical observation, classified TCM syndrome with quantification, then differentiated into 4 typed, hyperactivity of liver-fire, deficiency of Yin and hyperactivity of Yang, excessive accumulation of Phlegm dampness,and deficiency of both Yin and Yang. The 24h ambulatory blood pressure monitored were performed in standard position. SI was computed from systolic and diastolic ambulatory blood pressure. The statistics were analyzed with SPSS25.0 software.Results:141 cases of selected cases of male, female 59 cases, male to female ratio is about 7:3; ages up to 80 years of age in the most proportion of about 52%. The highest proportion of patients with merger of cerebral infarction (81.0%), merge coronary heart disease, diabetes, lower limb arteriosclerosis rates respectively were 33.5%,28.5%,11.5%. All patients with deficiency of Yin and hyperactivity of Yang maximum (35.0%), four kinds of syndromes are arranged in order of composition ratio deficiency of Yin and hyperactivity of Yang> excessive accumulation of Phlegm dampness> deficiency of both Yin and Yang> hyperactivity of liver-fire. Between different syndromes, there are significant gender differences in the proportions of statistics. Women have higher proportion in three kinds of syndromes deficiency of Yin and hyperactivity of Yang, deficiency of both Yin and Yang, excessive accumulation of Phlegm dampness. Males share certificate proportion more in excessive accumulation of Phlegm dampness and deficiency of both Yin and Yang. Distribution of different syndromes major in drug programs, and group differences in the frequency distribution is small. It can consider the impact of different drugs check against type in a balanced distribution between the two groups;. From individual drug situation, the impact of long-acting CCB check against type is more significantly, the P value is 0.019, which is less than the significance level of 0.05. Different Types disease (coronary heart disease, diabetes, cerebral infarction, lower limb arteriosclerosis) distributed in a balanced distribution between the groups, no statistically significant difference. Each clinical data multivariate analysis showed that Smoothness Index of Systolic Blood Pressure, SIS exist between the various syndromes significant difference P=0.002 (P<0.01), yin and yang type patients was significantly higher than that of SIS other groups, compared with the other three groups of syndromes exist significant differences (P<0.05). But among all age groups, Body Mass Index, BMI, systolic blood pressure, diastolic blood pressure, heart rate and Smoothness Index of Diastolic Blood Pressure, SID were compared. P values were greater than 0.05, showed no significant difference. Therefore, SIS may impact elderly hypertensive syndromes genotyping.Conclusion:Elderly patients with hypertension presented four syndromes-hyperactivity of liver-fire, deficiency of Yin and hyperactivity of Yang, excessive accumulation of Phlegm dampness deficiency of both Yin and Yang., mixed with the actual situation as the main feature. Deficiency of Yin and hyperactivity of Yang is the main characteristics and important pathogenesis in elderly hypertensive disease phenological. SI, as an index of the antihypertensive drug efficacy evaluation, shows that the higher SI, the more stable drug antihypertensive effect and lower SI, the less stable of patients’blood pressure regulation. Clinical studies evaluating the index as an indicator of blood pressure stability, and TCM syndromes associated findings suggest that patients with yin and yang SIS was significantly higher than the other groups, indicating SI elderly with essential hypertension relevant. Syndrome type can be used as an objective reference. Although patients with deficiency of Yin and hyperactivity of Yang regardless of type in SID or SIS were lower than the other three groups, the sample size may be less than normal. The result was not statistically significant in control, but such syndromes in patients with blood pressure control is not stable, more prone to various kinds of complications. Thus, the clinical focus of such patients should be closely monitored blood pressure, adjust the medication to achieve a more stable blood pressure status.