| Objective:By recording the blood pressure at 12 hours in elderly hypertensive patients with different syndromes and type 2 diabetes mellitus,the characteristics of blood pressure in different syndromes were analyzed,and the regularity of blood pressure changes and the mechanism of traditional Chinese medicine in elderly hypertensive patients with type 2 diabetes mellitus of different syndromes were discussed,so as to guide clinical work more effectively.Method:Fifty-six elderly hypertensive patients with type 2 diabetes mellitus and 194 elderly hypertensive patients with type 2 diabetes mellitus were selected from the endocrinology department and cardiovascular department of Guangzhou Hospital of Traditional Chinese Medicine.They were divided into simple group of 56(elderly hypertensive patients without type 2 diabetes mellitus)and combined group of 194(elderly hypertensive patients with type 2 diabetes mellitus).Comparing the difference between the two groups,and then comparing the composition of syndromes,24-hour mean systolic pressure(24hSBP),24-hour mean diastolic pressure(24hDBP),24-hour mean pulse pressure(24hPP),day mean systolic pressure(dSBP),day mean diastolic pressure(dDBP),day mean pulse pressure(dPP),night mean systolic pressure(nSBP),night mean diastolic pressure(nDBP),night mean diastolic pressure(nDBP)of the combined group,mean pulse pressure(nPP),and the circadian rhythm of ambulatory blood pressure(dipper/non-dipper).The 24-hour blood pressure fluctuation of each group was recorded,and the average blood pressure of two hours corresponding to the time was taken as the blood pressure index at that time.The time of entering the meridian flow method of TCM was divided into 12 hours.Explain its etiology and pathogenesis with TCM theory,and summarize the relevant influencing factors.Result:1.Two independent samples t-test showed that the 24-hour mean diastolic pressure(24hDBP)in the combined group was significantly higher than that in the simple group(t=3.796,P=0.000<0.01),the 24-hour mean pulse pressure difference(24hPP)in the simple group was significantly higher than that in the combined group(t=0.-4.968,P-0.000<0.01),and the combined group was higher than that in the simple group;the diurnal mean diastolic pressure(dDBP)was significantly different(t=3.622,P=0.01).00<0.01),the average diurnal pulse pressure difference(dPP)was significantly higher in the simple group than in the combined group(t=-0.5.091,P=0.000<0.01),and the combined group was higher than that in the simple group;the average night diastolic pressure(nDBP)was significantly different(t=3.008,P-0.003<0.01),the simple group was higher than the combined group;the average night pulse pressure difference(nPP)was significantly different(t=-3.854.258,P=0.000<0.01),and the combined group was significantly different(t=-3.854.258,P=0.000<0.01).It was higher than the simple group.2.The changes of blood pressure at different time in the simple group and the combined group were compared.Two independent samples t-test showed that the diastolic blood pressure at Zishi(the period of the day from 11 p.m.to 1 a.m.)was different between the combined group and the simple group(t=2.518,P=0.012<0.05),and the combined group was higher than the simple group;the systolic blood pressure at Choushi(the period of the day from 1 a.m.to 3 p.m)was different(t=2.362,P=0.019<0.05),the simple group was higher than the combined group;the diastolic blood pressure at Yinshi(the period of the day from 3 a.m.to 5 a.m.)was signif'icantly different(t=2.624,P=0.009<0.01),and the simple group was higher than the combined group;the diastolic blood pressure at the Maoshi(the period of the day from 5 a.m.to 7 a.m.)was significantly different(t = 4.420,P=0.000<0.01),the diastolic blood pressure of simple group was higher than that of combined group;the diastolic blood pressure of Chenshi(he period of the day from 7 a.m.to 9 a.m.)in simple group was higher than that of combined group(t=5.151,P=0.000<0.01),the diastolic blood pressure of simple group was higher than that of combined group in Sishi(the period of the day from 9a.m.to 11 a.m.)(t=2.647,P=0.01),the diastolic blood pressure of simple group was higher than that of combined group at Wushi(t he period of the day from 11 a.m.to 1 p.m.)(t=3.031,P=0.003<0.01),the diastolic blood pressure of simple group was higher than that of combined group at Shenshi(the period of the day from 3 p.m.to 5 p.m.)(t=2.575,P=0.011<0.05)the diastolic blood pressure at Xushi(the period of the day from 7 p.m.to 9 p.m.)was significantly different(t=3.370,P=0.001<0.01),higher in the simple group than in the combined group;the systolic blood pressure at Haishi(the period of the day from 9 p.m.to 11 p.m.)was significantly different(t=2.915,P = 0.004<0.01),higher in the combined group than in the simple group;and the diastolic blood pressure at Hai time was higher than in the combined group(t=2.141,P=0.033<0.05).3.Among 250 patients,only 8 had dipper blood pressure rhythm,of which 8 in the combined group and 0 in the simple group.The dipper curve group was significantly lower than the non-dipper curve group(P<0.05).4.Among 194 elderly hypertension patients with type 2 diabetes mellitus,the two most common syndromes were yin-yang deficiency type and liver-kidney Yin deficiency type,accounting for 35.57%and 34.54%respectively,followed by phlegm-mongolia Qingqiao type,accounting for 16.49%,followed by blood stasis Qingqiao type,accounting for 10.31%,and liver-yang hyperactivity type,accounting for 3.03%.5.The 12-hour mean systolic blood pressure fluctuations in the combined group and the simple group are as follows.It is known that the systolic pressure in the combined group is higher than that in the simple group in most of the time.The peak time of systol is pressure in the simple group is at Chenshi(7:00-9:00),the second peak time is Youshi(17-19:00),Zishi(23:00-1:00)is the lowest;the peak time of systolic blood pressure in thecombined group is at Youshi(17:00-19:00),and the second peak time is at Sishi(9:00?11:00)The lowest was Yinshi(3:00-5:00).6.Comparing ABPM basic values of elderly hypertension patients with different syndromes and type 2 diabetes mellitus,fewer cases excluding hyperactivity of liver-yang were excluded from the comparison.The remaining syndromes were analyzed by one-way ANOVA.There were differences among the four syndromes.(F=2.673,P=0.049<0.05),and there were no significant differences among the other four groups(P>0.05).7.The difference of systolic blood pressure and diastolic blood pressure at different time was found among the four groups(P=0.035,0.044<0.05),but there was no significant difference among the other four groups(P)0.05).8.The fluctuation of mean systolic pressure and diastolic pressure of four syndrome types at different time is as follows.It can be seen that the systolic pressure of Yin-Yang deficiency type and blood stasis clearance type forms "three peaks" and "four peaks".The fluctuation frequency of blood pressure is relatively high.The peak value of systolic pressure of Yin-Yang deficiency type is in Xushi,Maoshi and Choushi,and the valley value is in Weishi,Yin shi and Xushi,and the peak value of diastolic pressure is in Chenshi and Youshi,and the valley value is in Yinshi,Weishi.The peak values of systolic pressure of blood stasis clearance type were in turn in Yinshi,Mao shi,Sishi and Shen Shi,and the valley value is in Weishi,Xushi,Choushi,Chenshi.And the peak values of diastolic pressure were in turn in Chenshi,Youshi and Yin Shi,and the peak values of diastolic pressure were in turn in Chen Shi,Youshi and Yinshi,alley value is in Weishi,Choushi.While the peak values of systolic pressure of Yin deficiency type of liver and kidney were the farthest from the trough and the amplitude was larger than the other three types,and the peak values were in turn in Youshi,Youshi,Sishi,Wushi,valley value were in Choushi,Weishi in turn.and the peak diastolic pressure was in turn at ugly hour and unexpected hour,the peak of diastolic pressure was in Youshi and Chenshi,the valley value was in turn at Zishi and Weishi;the peak of diastolic pressure of Tanmeng Qingqiao type was in turn at Chenshi and Youshi,valley value were in Shenshi,and the peak of diastolic pressure was in turn at Youshi,Sishi,Wushi.the valley value was in turn at Zishi and Weishi.Conclusion:1.Of 194 patients in the combined group,only 8 had normal blood pressure rhythm,which was significantly lower than 186 patients with non-dipper curve,while 56 patients in the simple group had no blood pressure rhythm.2.Systolic blood pressure in the combined group is generally higher than that in the simple group,while diastolic blood pressure is lower,so the pulse pressure difference is larger.At different times,the peak of systolic blood pressure time of simple group was in Chenshi(7:00-9:00),the second peak was in Youshi(17:00-19:00),the peak time of combined group was in Youshi(17:00-19:00),the second peak was in Sishi(9:00-11:00),and the systolic blood pressure of combined group was higher than that of simple group in most periods.3.The two syndromes in the combined group accounted for the largest proportion were Yin-Yang deficiency,deficiency-Yang Waiyue syndrome and liver-kidney Yin deficiency syndrome,followed by phlegm,Mongolia and Qingqiao syndrome,followed by blood stasis and Qingqiao syndrome,and the lowest proportion was liver-yang hyperactivity syndrome.4.The fluctuation of mean systolic pressure and diastolic pressure of four syndrome types at different time is as follows.It can be seen that the systolic pressure of Yin-Yang deficiency type and blood stasis clearance type forms "three peaks" and "four peaks".The fluctuation frequency of blood pressure is relatively high.The peak value of systolic pressure of Yin-Yang deficiency type is in turn at Xushi,Maoshi,Choushi,and the valley value is in turn at Weishi,Yinshi,Xushi,and the peak value of diastolic pressure is in turn at Chenshi,Youshi.and the valley value is in turn at Yinshi,Weishi.The peak values of systolic blood pressure in blood stasis clearance type were in turn in Maoshi,Sishi and Shenshi,and the valley value is in turn at Weishi,Xushi,Choushi,Chenshi,and the peak values of diastolic blood pressure were in turn in Chenshi,Youshi and Yinshi,the valley value is in turn at Weishi,Choushi.while the peak values of systolic blood pressure in Yin deficiency type of liver and kidney were the farthest from the trough,and the amplitude was larger than the other three types,and the peak values were in turn in Youshi,Sishi,Wushi.the valley value is in turn at Choushi,Weishi,The peak values of diastolic blood pressure are Youshi,Chenshi,the valley value is in turn at Zishi,Weishi.The peak values of systolic blood pressure of Tanmeng Qingqiao type are Chenshi,Youshi,he valley value is at Shenshi.The peak values of diastolic blood pressure are Youshi,Sishi,Wushi.the valley value is in turn at Zishi,Weishi,... |
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