Study On The Correlation Between The Distribution Of TCM Syndrome Types And Clinical Indicators With Salt-sensitive Hypertension

ObjectiveExploring the distribution characteristics of TCM syndrome types of salt sensitive hypertension,and analyze the correlation between different TCM syndrome types and clinical indicators such as renal function,blood glucose,blood lipids,salt intake and ambulatory blood pressure,so as to provide objective reference basis for TCM syndrome differentiation.MethodsA total of 232 hypertensive patients who were hospitalized in the hypertension center of Kunming Yan’an hospital from October 2021 to December 2022 and met the inclusion and exclusion criteria were selected.According to the diagnostic criteria for TCM syndrome types in this study,TCM syndrome differentiation can be divided into four types:yin-yang deficiency,yin deficiency and yang hyperactivity,liver-fire hyperactivity,and excessive phlegm-dampness.All patients underwent salt sensitivity measurement,general data collection,renal function,blood glucose,blood lipids,24h urine electrolytes,24h urine protein,ambulatory blood pressure and other examinations.After collecting and sorting out the data,SPSS27.0 was used for data statistics and analysis.Results1.Among 232 patients with essential hypertension,154(66.4%)were salt sensitive and 78(33.6%)were non-salt sensitive.2.The distribution of TCM syndromes of salt sensitive hypertension:excessive phlegm-dampness syndrome>liver-fire hyperactivity syndrome>yin deficiency and yang hyperactivity syndrome>yin-yang deficiency syndrome.3.Salt sensitive hypertension patients with excessive phlegm-dampness syndrome had the highest salt intake,while yin deficiency and yang hyperactivity syndrome had the lowest salt intake.4.There were statistically significant differences in age,gender,BMI,drinking history and hypertension classification among the TCM syndromes of salt sensitive hypertension(P<0.05).The age of excessive phlegm-dampness syndrome was the youngest,and that of yin-yang deficiency syndrome was the oldest;The syndromes of liver-fire hyperactivity and excessive phlegm-dampness were mostly male,while the syndromes of yin deficiency and yang hyperactivity and yin-yang deficiency were mostly female;BMI was the highest in excessive phlegm-dampness syndrome and the lowest in yin deficiency and yang hyperactivity syndrome;The TCM syndromes of grade 3 hypertension are mainly liver-fire hyperactivity syndrome and excessive phlegm-dampness syndrome.5.There were statistically significant differences in UA,e GFR,24h urinary protein and 24h urinary microalbumin among different TCM syndromes of salt sensitive hypertension(P<0.05).The blood uric acid level of liver-fire hyperactivity was the highest,while yin-yang deficiency was the lowest;The e GFR level of excessive phlegm-dampness syndrome was the highest,and that of yin-yang deficiency syndrome was the lowest;The levels of 24h urinary protein and 24h urinary microalbumin were the highest in yin-yang deficiency syndrome.6.There were statistically significant differences in TC,LDL-C,and HDL-C among different TCM syndromes of salt sensitive hypertension(P<0.05).The average levels of TC and LDL-C were the highest in the excessive phlegm-dampness;The average level of HDL-C was the highest in yin deficiency and yang hyperactivity syndrome.7.There were no significant differences in smoking history,family history,SBP in the consulting room,DBP in the consulting room,Cr,BUN,GLU,blood Na~+,blood K~+,TG among the TCM syndromes of salt sensitive hypertension(P>0.05).8.There was statistically significant differences in the whole day ADBP,daytime ADBP and nighttime ADBP among different TCM syndromes of salt sensitive hypertension(P<0.05),but there were no statistically significant differences in the whole day ASBP,daytime ASBP and nighttime ASBP(P>0.05).The highest average blood pressure was seen in the excessive phlegm-dampness syndrome,while the lowest was observed in the yin-yang deficiency syndrome.9.In this study,the age,BMI,TC of salt-sensitive hypertensive patients were negatively correlated with liver-fire hyperactivity,age was negatively correlated with excessive phlegm-dampness syndrome,BMI was positively correlated with excessive phlegm-dampness syndrome,BMI was negatively correlated with yin deficiency and yang hyperactivity syndrome.Conclusion1.The detection rate of salt sensitivity in patients with essential hypertension in this study was about 66.4%.2.The distribution rule of TCM syndrome types in salt sensitive hypertension patients was:excessive phlegm-dampness syndrome>liver-fire hyperactivity syndrome>yin deficiency and yang hyperactivity syndrome>yin-yang deficiency syndrome.3.Salt sensitive hypertension patients with excessive phlegm-dampness syndrome had the highest salt intake,while yin deficiency and yang hyperactivity syndrome had the lowest salt intake.4.In this study,there was a positive or negative correlation between TCM syndrome types and influencing factors in salt sensitive hypertension patients:age,BMI,TC and liver-fire hyperactivity syndrome were negatively correlated;There was a negative correlation between age and excessive phlegm-dampness syndrome;BMI was positively correlated with excessive phlegm-dampness syndrome;BMI was negatively correlated with yin deficiency and yang hyperactivity syndrome.