Study On The Correlation Between Blood Pressure Variability And TCM Syndromes In Patients With Essential Hypertension

Purpose:By studying the circadian rhythm of blood pressure and its related influencing factors in patients with essential hypertension,the relationship between blood pressure variability and TCM syndromes was discussed,and the related factors of blood pressure variability were clarified,which provided objective basis for TCM dialectical typing of hypertension.Methods:200 inpatients from March 2018 to November 2018 in the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine were collected.General clinical data,ambulatory blood pressure,ambulatory electrocardiogram,color Doppler echocardiography and biochemical examination data were collected.According to the decrease rate of systolic blood pressure at night,the patients were divided into dipper type group,non-dipper type group and reverse dipper type group.According to symptoms and signs,the patients were divided into four TCM syndromes: hyperactivity of liver-fire,hyperactivity of yin-yang,deficiency of Yin-Yang and hyperactivity of phlegm-dampness.The collected data were analyzed statistically.Results: 1.41 cases(20.5%)of hyperactivity of liver-fire,66 cases(33%)of Yin-Deficiency and yang-excess,62 cases(31%)of Yin-Yang deficiency and 31 cases(15.5%)of phlegm-dampness congestion in 200 patients with essential hypertension.2.There were significant differences in age,coronary heart disease,BA,SDANN,NDI,RMSSD,LVEF,NT-pro BNP,Hcy,CTNT and HGB between dipper group,non-dipper group and reverse dipper group(P < 0.05).Logistic regression analysis was used to analyze the correlation of hypertension rhythm in patients with hypertension.Logistic regression analysis was used to select binary variables.The abnormal circadian rhythm of blood pressure group(non-dipper group + reverse dipper group)was taken as dependent variable.Age,coronary heart disease,SDNN,SDANN,SDNN Index,RMSSD,LVEF,NT-pro BNP,Hcy,CTNT and HGB were taken as independent variables to The correlation between circadian rhythm of patients.Multivariate logistic regression analysis showed that the circadian rhythm of blood pressure was positively correlated with age and history of coronary heart disease(P < 0.05),while the circadian rhythm of blood pressure was negatively correlated with index and LVEF(P < 0.05).3.The analysis of ambulatory blood pressure indicators in patients with essential hypertension of different TCM syndromes showed that there were significant differences in the nocturnal systolic pressure drop rate,nocturnal diastolic pressure drop rate,nocturnal mean systolic pressure,d SSD and n SSD of hyperactivity of liver-fire syndrome,Yin-deficiency and yang-hyperactivity syndrome,yin-yang deficiency syndrome,phlegm-dampness congestion syndrome(P < 0.05).Compared with Yin-Yang deficiency syndrome,the nocturnal systolic pressure and diastolic pressure of liver-fire hyperactivity syndrome and phlegm-dampness stagnation syndrome were significantly higher(P < 0.05);compared with Yin-Yang deficiency syndrome,the nocturnal mean systolic pressure of liver-fire hyperactivity syndrome and phlegm-dampness stagnation syndrome was significantly lower(P < 0.05);compared with liver-fire hyperactivity syndrome,the d SSD of Yin-Yang hyperactivity syndrome and yin-yang deficiency syndrome was significantly lower(P < 0.05).Compared with hyperactivity of liver-fire,n SSD of Yin-Yang deficiency syndrome was significantly higher(P < 0.05).Conclusions: 1.It was found that abnormal circadian rhythm of blood pressure was common in patients with essential hypertension.2.It was found that the decrease of nocturnal systolic blood pressure was related to age,coronary heart disease,SDANN,index,RMSSD,LVEF,NT-pro BNP,HCY,CTNT and HGB.Age,coronary heart disease,index and LVEF were independent factors affecting the circadian rhythm of blood pressure.3.According to the research,Yin-deficiency and Yang-excess syndrome and Yin-yang deficiency syndrome are the most common types of essential hypertension patients.4.The study found that in patients with essential hypertension,the nocturnal blood pressure decline rate of Yin-deficiency and Yang-deficiency syndrome and Yin-yang-deficiency syndrome were lower.The n SSD and d SSD of ambulatory blood pressure of different TCM syndromes were different.The n SSD of Yin-yang deficiency syndrome was higher than that of liver-fire hyperactivity syndrome.