| Research objective:On patients with primary hypertension circadian distribution of symptoms and risk factors of gender and age with the correlation of syndrome of hypertension grade of target-organ damage from the angle of time medicine twelve shi-chenm to explore the characteristics of circadian rhythm of hypertension, as to provide theoretical basis for the syndrome differentiation and treatment of high blood pressure, improve the clinical curative effect.Research methods:Clinical cases observation table design, by analyzing in the outpatient and ward to collect high blood pressure patients 24 hours ambulatory blood pressure circadian rhythm is normal, the collected patients can be divided into two groups, one group A for circadian rhythm normal group; Group B for the main content of the abnormal circadian rhythm group to collect general information TCM four diagnostic information using SPSS 17.0 statistical software to analyze the collected data.Research results:1. In 102 cases of the patients, group A (normal circadian rhythm) of 44 cases, B group of 58 cases (abnormal circadian rhythm), including non dipper type 53 people; The scoop type 5 people; Super scoop type 0. The circadian distribution of primary hypertension from big to small in turn is:non dipper type> scoops the scoop type> super scoop type.2.Different age groups have significant difference in terms of circadian rhythm of statistical significance. Group A are mainly distributed in 40-49 and 50-59, the proportion of 36.36% and 29.55% respectively. And group B are mainly distributed in 50-59 years old and 60-69 years old, the proportion is 34.48%, followed by 70-80, the proportion of 22.41%. Less than 40 and 40-49 of group A (9.10%,36.36%) is significantly higher than group B (1.72%, 6.90%).60-69 and 70-80 years the proportion of the number of group B (34.48%,22.41%) is significantly higher than group A (20.45%,4.55%).3.The differences between the different gender groups in terms of circadian rhythm has no statistical significance. There are 25men and 19 women in group A.There are 30men and 28 women in group B.4.The differences between the different risk factors in the aspect of circadian rhythm has no statistical significance. The top three risk factors are family history, high salt diet, obesity, accounted for 58.82%,55.88% and 48.04% respectively. The first risk factor of group A is family history, such as the proportion of 72.73%.The first risk factor of group B is high salt diet, the proportion of 67.24%.5.Different symptoms have significant difference in terms of circadian rhythm of statistical significance. Incidence of adjoint symptoms from high to low before three is in turn:dizziness, dry eyes, lumbar debility. In group A, the distribution of most symptoms are GanYan dry mouth, dizziness, dry eyes, accounted for 79.55%,77.27% and 72.73% respectively. In group B, the distribution of most symptoms of dizziness, respectively lumbar debility, dry eyes, accounted for 87.93%,86.21% and 68.97% respectively. GanYan dry mouth, mouth pain symptoms in group A (79.55%,70.45%) was significantly higher than that of group B (43.10%,25.86%). Pain in lumbar debility, leader, night cold symptoms of frequent urination, and cold limbs in group B (86.21%,62.07%,37.93%,37.93%) were significantly higher in group A (29.55%,29.55%,9.09%,6.82%).6.Different syndrome have significant difference in terms of circadian rhythm of statistical significance. A group of patients suffered with KangCheng, Yin deficiency hand, phlegm dampness indicates sheng is given priority to, the proportion of 36.36%,34.09% and 22.73% respectively. B group of patients with Yin deficiency hand, phlegmy wet indicates sheng, Yin deficiency syndrome is given priority to, the proportion of 36.21%,31.03% and 22.41% respectively. Group A something KangCheng syndrome (36.36%) is significantly higher than the proportion of group B (10.34%). The proportion of group B both Yin and Yang deficiency syndrome (22.41%) is significantly higher than group A (6.82%).7.And grade of different high blood pressure have significant difference in terms of circadian rhythm of statistical significance. Group A are mainly composed of high blood pressure, high blood pressure,2 level, the proportion of 36.36%,43.18% respectively. Group B mainly level 2, hypertension level 3, the proportion of 43.10%,50.00% respectively. Group A in the proportion of high blood pressure level 1 (36.36%) was obviously higher than group B (6.90%). Group B in hypertension level 3 proportion (50.00%) was significantly higher in group A (20.45%).8.Different hypertension syndrome in hypertension grade differences have a significant statistical significance. Grade 1 hypertension is given priority to with something KangCheng certificate, the proportion of 55%. Grade 2 hypertension with Yin hand syndrome, phlegm dampness indicates sheng is given priority to, the proportion of 40.91%,29.55% respectively. Level 3 hypertension with Yin deficiency hand syndrome, phlegm dampness indicates sheng is given priority to, the proportion of 36.84%,31.58% respectively. Grade 2 hypertension compared with grade 1 hypertension, Yin deficiency in proportion to the hand and phlegmy wet indicates sheng group increased significantly. Level 3 and level 2 hypertension, compared to the proportion of Yin and Yang are two virtual group was obviously increased.9.Merging, heart disease, merge kidney disease group, combination of cerebrovascular disease group, merged atherosclerosis group compared with the pure hypertension group, the difference was statistically significant. Merger heart disease group, merge kidney disease, cerebrovascular disease group, merge hardening of the arteries of normal circadian rhythm ratio 30.00%,30.30%,28.89% and 22.22% respectively, are less than 54.29% pure hypertension group of normal circadian rhythms. Incidence of target organ damage of group B was obviously higher than that of group A. lO.In the ZiShi (P=0.009), HaiShi (P=0.037), systolic blood pressure of similar between the two groups have statistical significance. In the ZiShi (23:00-1:00), systolic blood pressure (127.25mmHg) of group B was obviously higher than that of group A systolic blood pressure (107.38mmHg). In HaiShi (21:00-23:00), systolic blood pressure (127.65mmHg) of group B was obviously higher than that of group A systolic blood pressure (108.25mmHg). In the ZiShi(P=0.035), MaoShi (P=0.043) and HaiShi (P=0.012), two groups of diastolic blood pressure difference was statistically significant. In the ZiShi (23:00-1:00), diastolic pressure (75.70mmHg) of B group was obviously higher than that of group A diastolic pressure (67.00mmHg). In MaoShi (05:00-07:00), diastolic pressure (80.93mmHg) of B group was obviously higher than that of group A diastolic pressure (72.00mmHg). In HaiShi (21:00-23:00), diastolic pressure (76.26mmHg) of B group was obviously higher than that of group A diastolic pressure (64.88mmHg).11.Something KangCheng group mean arterial pressure curve of the first peak appeared in ChenShi(07:00-09:00), the second peak appears in the YouShi (17:00-19:00); Nocturnal blood pressure drops at a rate of 10.66%. Yin deficiency group hand mean arterial pressure curve of the first peak appeared in ChenShi(07:00-09:00), the second peak appears in the YouShi (17:00-19:00); Nocturnal blood pressure drops at a rate of 7.22%. Phlegmy wet indicates sheng group mean arterial pressure curve of the first peak appeared in ChenShi (07:00-09:00), the second peak appears in the ShenShi (15:00-17:00); Nocturnal blood pressure drops at a rate of 6.25%. Two virtual group of Yin and Yang mean arterial pressure curve of the first peak appeared in MaoShi (05:00-07:00), the second peak appears in the YouShi (17:00-19:00); Nocturnal blood pressure drops at a rate of 3.57%.Research conclutions:The circadian rhythm of patients with essential hypertension distribution has the certain regularity, circadian rhythm was abnormal in the majority with non dipper type. Circadian rhythm and the distribution of age, with symptoms, syndrome, high blood pressure classification and correlated with target organ damage. Group A mainly distributed in the ages of 40 and 49 and 50 to 59 years old; Group B mainly distributed in 50-59 years old and 60-69 years old. Group A distribution of most symptoms are GanYan dry mouth; Group B most distribution are the symptoms of dizziness. Group A is given priority to with something KangCheng, Yin deficiency hand; Group B is given priority to with phlegm wet indicates sheng, Yin deficiency hand. Group A is given priority to with high blood pressure level 1 and grade 2 hypertension; Group B is given priority to with grade 2 and hypertension level 3. Incidence of target organ damage of group B was obviously higher than that of group A. A, B two groups of blood pressure difference is closely related to the hour blood lingers. In the ZiShi (23:00-1:00), HaiShi (21:00-23:00), systolic blood pressure of group B was obviously higher than that of group A systolic blood pressure. The ZiShi (23:00-1:00), MaoShi (05:00-07:00) and HaiShi (21:00-23:00), diastolic blood pressure of group B was obviously higher than that of group A diastolic blood pressure. Common TCM syndrome type of hypertension associated with hour blood lingers, the time medicine of traditional Chinese medicine theory is applied to the clinical syndrome differentiation of the disease medication, have certain guiding significance to improve the clinical curative effect.
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