| Objective: By collecting and investigating the data of cases in clinic,this paper probes into the correlation between blood pressure variability and depressive symptoms in patients with chronic kidney disease stage 1~3,and investigates the distribution of TCM syndrome type in patients with or without depressive symptoms,and analyzes the correlation between blood pressure variability and different syndrome types in order to provide new ideas for clinical treatment of TCM.Methods: to design the research scheme,select the outpatients and inpatients of Dongzhimen Hospital of Beijing University of traditional Chinese Medicine,collect the general situation and psychological and emotional status of the patients with chronic kidney disease in the form of clinical questionnaire.Laboratory indexes and TCM syndrome differentiation and other data,and through ambulatory blood pressure monitoring instrument to meet the requirements of the 24-hour blood pressure monitoring.Excel software was used to establish the database,collate and input the data.The data were statistically analyzed by SPSS 22.0 software.The measurement data were expressed by mean ±standard deviation(s),F test was used for comparison among several groups,and F test was used for comparison between two groups.Non-paired t-test was used for comparison.The counting data were statistically analyzed by chi-square test.Results:(1)General situation analysis: in this study,96 patients were included in the patients with CKD1 ~ 3,including 42 with depression and 54 with depression.There were 22 males and 20 females in the depression group.The average age was 61.5(13.7)years;in the control group,26 were male,28 were female,and the average age was 59.5(12.5)years.Of the 96 patients with chronic kidney disease,there were 34 cases of CKD1,35 in the CKD2 phase and 27 in the CKD3 period.Sex,age,basic disease,BMI,smoking history,history of drinking,TC,Glu,Scr,systolic blood pressure(SBP),and diastolic blood pressure(SBP)in both groups There was no significant difference in DBP(P > 0.05).(2)Correlation between blood pressure variability and depressive symptoms in patients with CKD : the blood pressure variability in CKD1~3 patients with depressive symptoms was higher than that in the control group,in which 24 hours systolic blood pressure variation coefficient and 24 hour diastolic blood pressure variation coefficient were higher than those in the control group.The coefficient of variation of daytime systolic blood pressure and nocturnal systolic blood pressure were significantly higher than those of the control group(P < 0.01).(3)The distribution of TCM Syndromes in CKD : 42 patients with chronic kidney disease with depressive symptoms,the distribution of this syndrome is spleen-kidney yang deficiency syndrome > liver-kidney yin deficiency syndrome > spleen-kidney qi deficiency syndrome > lung-kidney qi deficiency syndrome > qi-yin deficiency syndrome,and the spleen-kidney yang deficiency syndrome is the most common syndrome.Accounted for 38.1%,followed by liver-kidney yin deficiency syndrome,accounting for 31.0%.There were 20 cases of blood stasis syndrome,accounting for 47.6%.54 cases of chronic kidney disease without depressive symptoms were diagnosed as syndrome types of traditional Chinese medicine(TCM),and the distribution of syndrome was blood stasis > damp-turbidity > damp-heat,among which 20 cases were blood-stasis syndrome,accounting for 47.6%.The distribution of the syndrome is lung-kidney qi deficiency syndrome > spleen-kidney yang deficiency syndrome > qi-yin deficiency syndrome > liver-kidney yin deficiency syndrome,in which the lung-kidney qi deficiency syndrome is the most.Accounted for 35.2%,followed by spleen and kidney qi deficiency syndrome,accounting for 31.5%.There were 22 cases of damp-heat syndrome,accounting for 40.7%.(4)The correlation between TCM syndrome type and blood pressure variability: in the distribution of CKD,compared with spleen-kidney qi deficiency syndrome group,the SBPCV,DBPCV,dDBPCV,nDBPCV index of spleen-kidney yang deficiency syndrome group is different,the DBPCV,dSBPCV,dDBPCV,nSBPCV,nDBPCV index of lung-kidney qi deficiency syndrome group is different.There were differences in dSBPCV,dDBPCV,nDBPCV index between liver and kidney yin deficiency group.Compared with the syndrome of deficiency of spleen and kidney yang,the index of SBPCV,dSBPCV,nDBPCV in the group of deficiency of lung and kidney qi has obvious difference.S of group of deficiency of liver and kidney yin There were significant differences in BPCV,DBPCV,dSBPCV,dDBPCV,nSBPCV,nDBPCV indexes.Compared with the lung-kidney qi deficiency group,the DBPCV,dDBPCV,nSBPCV,nDBPCV indexes in the liver-kidney yin deficiency group were different from those in the lung-kidney qi deficiency group.There was no significant difference in blood pressure variability in Qi-yin deficiency syndrome group due to the small sample size.In CKD syndrome,compared with damp-heat syndrome group and damp-turbid syndrome group,the SBPCV,DBPCV,dSBPCV,dDBPCV,nSBPCV,nDBPCV indexes in blood stasis syndrome group were significantly different;damp-turbid syndrome was the same as that in damp-heat syndrome group and damp-turbid syndrome group.Compared with damp-heat syndrome group,there was significant difference in DBPCV,dDBPCV,nDBPCV index between the two groups.Conclusion:(1)Depressive symptoms can significantly increase blood pressure variability in patients with CKD1~3.(2)The distribution of TCM syndromes in CKD1~3 patients with or without depressive symptoms was different: the syndrome of spleen-kidney yang deficiency in CKD patients with depression was the most,accounting for 38.1%.The distribution of markers was mainly blood stasis syndrome,accounting for 47.6%.The lung-kidney qi deficiency syndrome was the most common in CKD patients without depressive symptoms,accounting for 35.2%.The distribution of signs was mainly damp-heat syndrome,accounting for 40.7%.(3)There was a certain correlation between blood pressure variability and TCM syndrome type in patients with CKD1~3. |
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