Objective To investigate the syndrome type distribution of hypertensive patients; To analyze the correlation of characteristics of HRV time domain parameters and its influence factors. Methods Totally 515 cases of hypertensive patients were included and were put under syndrome type distribution. Demographic information, laboratory test parameters, risk factors and clinical symptoms were collected for correlation analysis. HRV time domain parameters were recorded by using 24 h ambulatory electrocardiogram. The differences in SDNN, SDNN Index, HRV Index, PNN50, and RMSSD of different TCM syndrome types were compared. Results Among 515 patients: 160 cases with hyperactivity of yang due to yin deficiency syndrome, 136 cases with turbid phlegm and blood stasis syndrome, 83 cases with overabundant liver-fire syndrome, 69 cases with deficiency of kidney qi, and 67 cases with abundant phlegm-dampness syndrome. By comparing different TCM syndromes, the level of SDNN was significantly reduced in the hyperactivity of yang due to yin deficiency syndrome, overabundant liver-fire syndrome,deficiency of kidney qi syndrome compared with turbid phlegm and blood stasis syndrome, abundant phlegm-dampness syndrome (P<0.05); SDNN Index and HRV Index decreased significantly in the hyperactivity of yang due to yin deficiency and overabundant liver-fire syndrome compared with abundant phlegm-dampness syndrome (P<0.05). SDNN Index decreased significantly in the deficiency of kidney qi compared with abundant phlegm-dampness syndrome (P<0.05). The level of PNN50 was significantly reduced in the deficiency of kidney qi compared with hyperactivity of yang due to yin deficiency syndrome (P<0.05). RMSSD decreased significantly in the hyperactivity of yang due to yin deficiency syndrome, deficiency of kindney qi syndrome, overabundant liver-fire syndrome compared with turbid phlegm and blood stasis syndrome (P<0.05). Discriminant analysis showed that SBP, DBP, MBPS, SDNN, SDNN Index, HRV Index, PNN50, RMSSD were correlated with the diagnosis of five syndrome types. Logistic regression analysis showed that the factors including gender (female), insomnia, elevated systolic blood pressure, MBPS, decreased SDNN Index and PNN50 were positively correlated to hyperactivity of yang due to yin deficiency; other factors including gender (female), advanced age, elevated blood pressure, decreased SDNN, HRV Index and RMSSD were positively correlated with turbid phlegm and blood stasis syndrome. And the study also showed that advanced age, family history of hypertension, elevated blood pressure, decreased SDNN Index, HRV Index and PNN50 were positively correlated to abundant phlegm-dampness syndrome. Conclusion HRV time domain parameters can be significantly reduced in the hyperactivity of yang due to yin deficiency, overabundant liver-fire syndrome, and deficiency of kidney qi syndrome. The autonomic nerve function is damaged seriously. Hyperactivity of yang due to yin deficiency syndrome, abundant phlegm-dampness syndrome turbid phlegm and blood stasis syndrome are closely related to the influencing factors that lead to cardiovascular and cerebrovascular events.

Based on the theory of qi， blood and fluids， and taking into account of the pathogenesis evolution process from constraint to phlegm， stasis and then mass in pulmonary nodules， an attempt has been made to construct a three-dimensional differentiation system for pulmonary nodules from the dimensions of time and space. The temporal progression of the early， middle， and late stages of pulmonary nodules reflects the pathological changes from constraint to phlegm and then stasis in the metabolism disorders of qi， blood and fluid. The spatial structures such as size， density， and morphology of pulmonary nodules reflect the pathological states of the duration， severity， and primary and secondary conditions of qi， blood and fluid metabolism disorders. Based on the temporal progression， the therapeutic principles have been proposed， which are dispelling pathogenic factors and promoting the use of beneficial factors to interrupt the growth momentum in the early stage， removing turbidity and dispersing phlegm to reduce the degree of nodules in the middle stage， and dispersing nodulation and eliminating abnormalities in the late stage. Based on the spatial structures， the suggested therapeutic methods are using wind herbs， employing multiple approaches to treat phlegm， and promoting blood circulation to resolve stasis， so as to provide theoretical reference for the systematic diagnosis and treatment of pulmonary nodules in traditional Chinese medicine.