Study On The Correlations Between Circadian Rhythms Variation And Constitution Or Differentiation Of TCM Among Essential Hypertension Patients

Aim: In order to find out some new treatments and precautions about essential hypertension(EH)in Traditional Chinese Medicine(TCM),this study collected the patients with EH whose inspection report of 24-h ambulatory blood pressure and other clinical information,then analyzed the correlations between circadian rhythms variation and constitution,syndrome or biochemical indicators,and summarized the time features of extreme blood pressure,explaining how circadian rhythm could make variations in Qi transformation theory of TCM.Methods: All of the cases who agreed to accept a series of inspects or tests,including 24-h ambulatory blood pressure measurement,blood biochemistry,differentiation in Syndrome and constitution of TCM,and offer clinical information were from Cardiology Department,affiliated hospital attached to Shandong University of TCM during October 2020 to2021.They were divided into normal(dipper type)or abnormal group by the rhythm curve,but the latter included three subtypes(non dipper type,anti dipper type and deep dipper type).The differences between two groups were analyzed in a couple of factors that involved sex,age,the grade,the risk stratification,syndrome and constitution of TCM,besides the averages of mainly biochemical projects.While the rhythmic regularities were described in a great detail about maximum or minimum in blood pressure(systolic pressure,diastolic pressure and mean arterial pressure)with time distribution using in Twelve Tow-Hour,which was a regulation in Chinese traditional culture.Results: 1.The composition of sample: 152 cases were obtained that normal group contained 26 while the abnormalities were 126,including 74 non dipper types,50 anti dipper types and 2 deep dipper types.2.The comparison of baseline characteristics:(1)There was no difference between the normal and the abnormal in sex,age,course and grade of EH(P > 0.05).(2)There was a difference between two groups in risk stratification.The most rank was ‘high-risk’ in normal group while the abnormal was ‘extremely-high-risk’(P<0.05).3.The comparison of syndrome differentiation and constitution of TCM:(1)There was a difference between two groups in syndrome differentiation of TCM(P<0.05).The results were as follows: the order of type proportion in normal group was Kidney-Essence Deficiency Syndrome> Qi and Blood Deficiency Syndrome> Liver-Yang Hyperactivity Syndrome> Phlegm-Turbid Syndrome> Blood Stasis Syndrome,and the abnormal group was Phlegm-Turbid Syndrome> Blood Stasis Syndrome= Liver-Yang Hyperactivity Syndrome> Kidney-Essence Deficiency Syndrome> Qi and Blood Deficiency Syndrome.As for constitution of TCM,first of all,the normal group was mainly composed of simple cases,but the abnormal group usually contained more than two types,showing a different complexity in two group(P<0.05).The second question was what kind of mainly types the groups were.The number of different types in normal group were roughly equal,while the abnormal was focus on ‘ Qi-deficiency ’,‘ Phlegm-dampness ’ and‘Qi-stagnation’,however,this result was no significance in statistics(P = 0.07 > 0.05).(2)The comparison in abnormal group: Neither constitution nor syndrome differentiation did non dipper type and anti dipper type have a difference in(P>0.05)excluding deep dipper type because of its small sample size.4.The biochemical indicators in normal group and abnormal group: There was no difference between the normal and the abnormal from these data in blood sugar,blood fat and uric acid.5.The analysis of time characteristics in blood pressure:(1)General characteristics: Two groups showed a common uptrend in Yin-Chen time and Wei-You time obviously,but the abnormal curve,without a descend in night,was more gently than the other one.(2)Time in maximum blood pressure: There were two periods of time when blood pressure rose in both groups that the normal was at Chen and You while the abnormal was at Mao and You(P<0.05).(3)Time in minimum blood pressure: The normal group indicated a lowest blood pressure about Chou(P<0.05),while the other group was more ambiguous(P>0.05).Conclusion: 1.There was a common phenomenon in EH that abnormal circadian rhythms accounted for a larger proportion.The constitution types of these people became more complex than the normal,in other words,they would get multiple constitution results instead of the only.2.Phlegm-Turbid Syndrome,Blood Stasis Syndrome and Liver-Yang Hyperactivity Syndrome took up the majority among EH with abnormal circadian rhythms.Phlegm-dampness,blood-stasis and qi-stagnation were their vital pathogenic factors in TCM.3.The mainly abnormalities during 24-h were the acute morning blood pressure surging and weakened or disappeared overnight blood reducing,which were around at the period of the day from5 to 7 a.m and 1 to 3 a.m.