Research On The Correlation MBPS With NLR,PDW And Cys C In Hypertensive Patients With Different TCM Syndromes

Objective:To explore the relationship between Morning blood pressure surge(MBPS)and neutrophil to lymphocyte ratio(NLR),platelet distribution width(PDW)and serum Cystatin C(Cys C)in patients with hypertension of different TCM syndromes,to provide reference for the treatment of hypertension with traditional Chinese medicine.Methods:The general data,clinical manifestations,blood routine,biochemical tests,and24-hour ambulatory blood pressure of 476 hypertensive patients hospitalized in the Affiliated Hospital of Gansu University of Traditional Chinese Medicine from January,2019 to December,2022 were collected.According to the syndrome diagnostic criteria in"Vertigo Disease(Essential Hypertension)TCM diagnosis and Treatment Plan(Trial)",the collected hypertension patients were divided into 4 syndrome types(hyperactive liver fire syndrome,kidney qi deficiency syndrome,phlegm and blood stasis mutual accumulation syndrome,Yin deficiency and Yang excess syndrome).The relationship between MBPS and NLR,PDW,Cys C in patients with different TCM syndrome types of hypertension was explored.SPSS 25.0statistical software was used to process the data.Results:1.The 476 cases of hypertension were collected,including 73 cases of hyperactive liver fire syndrome(15.34%),100 cases of kidney qi deficiency syndrome(21.01%),176 cases of phlegm and blood stasis mutual accumulation syndrome(36.97%),127 cases of Yin deficiency and Yang excess syndrome(26.68%).There were 194 patients with morning blood pressure surge,33 cases(45.21%)with hyperactive liver fire syndrome,39 cases(39.00%)with kidney qi deficiency syndrome,63 cases(35.80%)with phlegm and blood stasis mutual accumulation syndrome,and 59 cases(46.46%)with Yin deficiency and Yang excess syndrome.2.The 476 cases of hypertension were collected,there were significant differences in NLR(H=25.005,P=0.000),PDW(H=30.720,P=0.000)and Cys C(H=15.693,P=0.001)among different TCM syndrome types of hypertension patients.The NLR level of phlegm and blood stasis mutual accumulation syndrome group was higher than that of hyperactive liver fire syndrome(P<0.05).The PDW level of Yin deficiency and Yang excess syndrome group was higher than that of phlegm and blood stasis mutual accumulation syndrome,hyperactive liver fire syndrome,and kidney qi deficiency syndrome(P<0.05).The level of Cys C in the kidney qi deficiency syndrome group was higher than that in the phlegm and blood stasis mutual accumulation syndrome and Yin deficiency and Yang excess syndrome(P<0.05).Among 194patients with morning blood pressure surge,there were significant differences in MBPS among different TCM syndromes(H=13.280,P=0.004),and MBPS in the group with phlegm and blood stasis mutual accumulation syndrome was higher than that in the group with kidney qi deficiency syndrome(P<0.05).3.The 476 cases of hypertension were collected,NLR(H=30.137,P=0.000),PDW(H=18.015,P=0.000),Cys C(H=12.401,P=0.000)were compared between 194 patients with morning blood pressure surge and 282 patients without morning blood pressure surge.between the two groups(P<0.05).NLR,PDW and Cys C were all higher in the morning peak group.4.Among 194 hypertensive patients with morning blood pressure surge,MBPS was positively correlated with NLR(r_s=0.346,P=0.000),PDW(r_s=0.213,P=0.003)and Cys C(r_s=0.195,P=0.006).5.Among 194 hypertensive patients with morning blood pressure surge,MBPS was positively correlated with NLR in hypertensive patients with kidney qi deficiency syndrome and Yin deficiency and Yang excess syndrome(r_s=0.397,r_s=0.281,P<0.05).MBPS was positively correlated with NLR,PDW and Cys C in hypertensive patients with phlegm and blood stasis mutual accumulation syndrome(r_s=0.266,r_s=0.259,r_s=0.319,P<0.05).Conclusions:1.There were differences in MBPS,NLR,PDW and Cys C among patients with different TCM syndromes.2.The levels of NLR,PDW and Cys C in hypertensive patients with morning blood pressure surge tended to increase with the increase of MBPS.MBPS of phlegm and blood stasis interaction syndrome,kidney qi deficiency syndrome,and Yin deficiency and Yang excess syndrome are all related to NLR,and MBPS of phlegm and blood stasis mutual accumulation syndrome is also related to PDW and Cys C.