| Objectives: By exploring the relationship between Traditional Chinese Medicine(TCM) and the sleep-time blood pressure of patients with chronic kidney disease from stage 1 to stage 4,and the effects of the sleep-time blood pressure and TCM on the prognosis in patients with chronic kidney disease.Method: This research had been approved by the ethics committee.The research object were the patients with chronic kidney disease that be treated in Hubei Provincial Hospital Of Traditional Chinese Medical from 2012 February to 2013 February,and everyone signed the informed consent.There were 154 patients qualified.We provide the portable dynamic blood pressure monitor to make the 154 patients have the 24 hours ambulatory blood pressure monitoring(ABPM).The program is set that 6:00 to 22:00 for daytime blood pressure, measured blood pressure once every 15min;and 22:00 to the next day 6:00 for sleep-time blood pressure, measured blood pressure once every 30 min.Ambulatory blood pressure monitoring values greater than 80% for effective monitoring.The monitoring data include 24 hour mean systolic blood pressure(24hm SBP), 24 hour average diastolic blood pressure(24hm DBP), daytime average systolic blood pressure(dm SBP), daytime average diastolic blood pressure(dm DBP), nocturnal mean systolic blood pressure(nm SBP), night diastolic blood pressure(nm DBP).Other assay data include urine protein in 24 hours.A follow-up of patients every 12 months, by the end of 2015 February, completed 24 months of follow-up.The sleep-time blood pressure mean is more than 120/70 mmhg as group A, the sleep-time blood pressure mean is less than 120/70 mmhg as group B.Compare the general information、TCM 、the distribution of 24 h urinary protein and prognosis assessment of A group and B group.Result:(1)There were 154 patients at the beginning of the research, then 1 patients in this research fall off, so the actual completion number of this research was 153 cases.(2)At 0 month,the average age of group A was 49.28±13.08 year,the average age of group B was 43.09±15.06 year,the difference was statistically significant(P <0.05);At 12 month,the average age of group A was 53.28±11.60 year,the average age of group B was 46.23±12.13 year,the difference was statistically significant(P <0.05);At 24 month,the average age of group A was 56.57±11.56 year,the average age of group B was 48.47±13.04 year,the difference was statistically significant(P <0.05). The correlation coefficient between the sleep-time systolic blood pressure mean and age was 0.31(P <0.01),there was a positive correlation between sleep-time systolic blood pressure mean and age.(3)At 0 month there was no statistically differences between group A and group B on deficiency type(P >0.05);at 12 month there were statistically differences between group A and group B on deficiency type,in the group A : liver and kidney yin deficiency syndrome is the most accounting for 40.6%,followed by spleen and kidney Yang deficiency syndrome accounting for 34.4%, spleen and kidney qi deficiency syndrome is the least accounting for 25.0%,in the group B: spleen and kidney qi deficiency syndrome is the most accounting for 52.0%,followed by spleen and kidney Yang deficiency syndrome accounting for 34.7%, spleen and iver and kidney yin deficiency syndrome is the least accounting for 13.3%;at 24 month there were statistically differences between group A and group B on deficiency type,in the group A : spleen and kidney Yang deficiency syndrome is the most accounting for 41.8%,followed by liver and kidney yin deficiency syndrome accounting for 36.4%,spleen and kidney qi deficiency syndrome is the least accounting for 21.8%,in the group B: spleen and kidney qi deficiency syndrome is the most accounting for 54.3%,followed by iver and kidney yin deficiency syndrome accounting for 24.3%,and spleen and kidney Yang deficiency syndrome is the least accounting for 21.4%.(4)There were statistically differences between the group A and group B on evil empirical type(P <0.05),in group A:turbid damp syndrome is the most accounting for 40.0%%,followed by damp-heat syndrome accounting for 33.7%, blood stasis syndrome accounting for 15.0%,heat toxin syndrome is the least accounting for 11.3%;in group B:blood stasis syndrome, is the most accounting for 38.4%,followed by damp-heat syndrome accounting for 26.0%,turbid damp syndrome accounting for 24.7%, and heat toxin syndrome is the least accounting for 10.9%.There were no statistically differences between the two groups at 12 and 24 month(P >0.05).(5)At 0 month the 24 h urinary protein of group A was 1.06±0.98 g,the 24 h urinary protein of group B was 0.70±0.64 g,the difference was statistically significant(P < 0.01);At 12 month the 24 h urinary protein of group A was 1.04±0.89 g,the 24 h urinary protein of group B was 0.67±0.57 g,the difference was statistically significant(P < 0.01);At 24 month the 24 h urinary protein of group A was 1.04±1.02 g,the 24 h urinary protein of group B was 0.57±0.56 g,the difference was statistically significant(P < 0.01).The correlation coefficient between the sleep-time systolic blood pressure mean and the 24 h urinary protein was 0.17(P <0.05),there was a positive correlation between sleep-time systolic blood pressure mean and the 24 h urinary protein.(6)The 24 months of follow-up were completed,a total of 31 patients enter the end event, among them, 6 cases of cerebrovascular disease outcome,22 cases of renal outcome.(7)The 31 patients ’s 24 h mean systolic blood pressure was 137.84±17.34 mm Hg, and their sleep-time mean systolic blood pressure was 128.52±19.59 mm Hg,the patients that were not enter the end event had a 24 h mean systolic blood pressure of 131.00±13.81 mm Hg, and their sleep-time mean systolic blood pressure were 119.33±19.87 mm Hg,there were statistically differences between the two group(P < 0.05).(8)The were statistically differences between group A and B on the progression of albuminuria(P < 0.01),the correlation coefficient was 0.23, after Logistic regression analysis between group A and group B, result was the urinary protein deterioration rate of group A was 2.6 times than B group. there were no statistically differences between the two group on the prognosis of outcome(P>0.05).(9)The deficiency of traditional Chinese Medicine had no correlation with the prognosis(P>0.05),the evil empirical of traditional Chinese Medicine had no correlation with the prognosis(P>0.05).Conclusion:(1)The sleep-time blood pressure mean had a correlation with age,perhaps the older people have the higher sleep-time blood pressure mean.(2)The sleep-time blood pressure affected TCM Deficiency type,but did not affected TCM evil empirical type.(3)Reduce sleep-time blood pressure could decrease the urinary protein excretion.(4)Reduce sleep-time blood pressure could relief the patients of urinary protein degradation.(5)The distribution of TCM Syndromes did not affected the prognosis of patients with CKD. |
PDF Full Text Request