LIU Zhi-jun,JIN Hua,HAN Yan-ping,et al.Analysis on Blood Pressure Variability and Its Influencing Factors of Hypertensive Patients with Different TCM Syndromes[J].zhongguo zhongyiyao xinxi zazhi,2018,25(4):35-39.[doi:10.3969/j.issn.1005-5304.2018.04.008]
不同中医证型高血压患者血压变异性及影响因素分析
- Title:
- Analysis on Blood Pressure Variability and Its Influencing Factors of Hypertensive Patients with Different TCM Syndromes
- 文章编号:
- 1005-5304(2018)04-0035-05
- 分类号:
- R259.441
- 文献标志码:
- A
- 摘要:
- 目的 调查高血压患者中医证型的分布情况，分析其血压变异性（BPV）参数特征及其影响因素的相关性。方法 纳入高血压患者515例，进行辨证分型，记录患者的人口学资料、实验室指标、危险因素及临床症状，并分析其相关性。采用24 h动态血压记录BPV参数，比较不同中医证型高血压患者BPV参数差异，包括24 h平均收缩压（24 h MSBP）、24 h平均舒张压（24 h MDBP）、24 h平均收缩压变异系数（24 h MSCV）、24 h平均舒张压变异系数（24 h MDCV）、日间（6:00－22:00）平均收缩压（DMSBP）、日间平均舒张压（DMDBP）、日间平均收缩压变异系数（DMSCV）、日间平均舒张压变异系数（DMDCV）、夜间（22:00－次日6:00）平均收缩压（NMSBP）、夜间平均舒张压（NMDBP）、夜间平均收缩压变异系数（NMSCV）、夜间平均舒张压变异系数（NMDCV）、夜间血压下降率。结果 阴虚阳亢证、痰瘀互结证、肝火亢盛证、肾气亏虚证、痰湿壅盛证分别为160、136、83、69、67例。不同证型间年龄、性别差异有统计学意义（P＜0.05）；与阴虚阳亢证比较，痰瘀互结证、肝火亢盛证、肾气亏虚证、痰湿壅盛证24 h MSBP、24 h MDBP、DMSBP、DMDBP、NMSBP、NMDBP及24 h MSCV、24 h MDCV、DMSCV、DMDCV、NMSCV、NMDCV差异有统计学意义（P＜0.05）。性别（女性）、睡眠时间＜6 h、摄入钠盐量、情绪激动、文化程度与阴虚阳亢证呈正相关；性别（女性）、年龄、摄入钠盐量、文化程度与痰瘀互结证呈正相关；年龄、摄入钠盐量、高血压家族史、文化程度与痰湿壅盛证呈正相关。结论 高血压阴虚阳亢证患者血压及BPV参数最高，高血压痰湿壅盛证患者血压及BPV参数最低；阴虚阳亢证、痰瘀互结证、痰湿壅盛证与引发高血压患者心脑血管事件的影响因素关系较为密切。
- Abstract:
- Objective To investigate the TCM syndrome type distribution of hypertensive patients; To analyze the correlation of blood pressure variability (BPV) parameters and its influence factors. Methods The data of 515 hypertensive patients including demographic information, laboratory test parameters, risk factors and clinical symptoms were collected for correlation analysis and the patients were divided to different TCM syndromes. BPV parameters of 515 hypertensive patients were acquired by 24 h ambulatory blood pressure, then our study analyzed and compared the differents of 24 h MSBP, 24 h MDBP, 24 h MSCV, 24 h MDCV, DMSBP, DMDBP, DMSCV, DMDCV, NMSBP, NMDBP, NMSCV, NMDCV between different TCM syndromes. Results There were 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. The difference of gender and age was statistically significant between different TCM syndromes (P<0.05). Compared with the group of hyperactivity of yang due to yin deficiency syndrome, the level of 24 h MSBP, 24 h MDBP, DMSBP, DMDBP, NMSBP, NMDBP, 24 h MSCV, 24 h MDCV, DMSCV, DMDCV, NMSCV and NMDCV had statistical significance in the groups of turbid phlegm and blood stasis syndrome, overabundant liver-fire syndrome, deficiency of kidney qi and abundant phlegm-dampness syndrome (P<0.05). Logistic regression analysis showed that the factors including gender (female), insomnia (time<6 h), sodium salt intake, emotion and educational level were positively correlated to hyperactivity of yang due to yin deficiency, and other factors including gender (female), age, sodium salt intake and educational level positively correlated with turbid phlegm and blood stasis syndrome. And the study also showed that age, sodium salt intake, family history of hypertension and educational level were positively correlated to abundant phlegm-dampness syndrome. Conclusion The BPV parameters and blood pressure are significantly increased d in the group of hyperactivity of yang due to yin deficiency than other groups, but decrease in the group of abundant phlegm-dampness syndrome. Hyperactivity of yang due to yin deficiency syndrome, abundant phlegm-dampness syndrome and turbid phlegm and blood stasis syndrome are closely related to the influencing factors that lead to cardiovascular and cerebrovascular events.
参考文献/References:
[1] 中华医学会心血管病学分会,中国老年学学会心脑血管病专业委员会.老年高血压的诊断与治疗中国专家共识(2011版)[J].中国医学前沿杂志(电子版),2012,4(2)：31-39. [2] 刘志军,金华,苏莉莉,等.不同中医证型高血压患者心率变异性及其影响因素分析[J].中国中医药信息杂志,2017,24(9)：15-20. [3] 郑筱萸.中药新药临床研究指导原则(试行)[M].北京：中国医药科技出版社,2002：73-77.
[4] SHANTHI M, LARS H L, GIUSEPPE M, et al. World Health Organization (WHO) and International Society of Hypertension risk prediction charts：assessment of cardiovascular risk for prevention and control of cardiovascular disease in low and middle-income countries[J]. J Hypertens,2007,25(8)：1578-1582. [5] 中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华高血压杂志,2011,19(8)：701-743. [6] 国家中医药管理局医政司.眩晕病(原发性高血压)中医临床路径实施方案(试行)[M].北京,2012：45-51. [7] 周仲瑛.中医内科学[M].北京：中国中医药出版社,2011：297-304. [8] JCS JONIT WORKING GROUP. Guidelines for the clinical use of 24 hour ambulatory blood pressure monitoring (ABPM) (JCS 2010)[J]. Cir J,2012,76(2)：508-519. [9] WANG J W, ZHANG L X, WANG F, et al. Prevalence, awareness, treatment, and control of hypertension in China：results from a national survey[J]. American Journal of Hypertension,2014, 27(11)：1355-1361. [10] KIKUYA M, OHKUBO T, SATOH M, et al. Prognostic significance of home arterial stiffness index derived from self-measurement of blood pressure：the Ohasama Study[J]. Am J Hypertens,2012, 25(1)：67-73. [11] 肖强.年龄、性别和体重指数与老年人群高血压、高血糖和高血脂的关系[J].中国老年学杂志,2011,31(18)：3626-3627.
[12]
马孝湘,陈晓平,
程幼夫,等.绝经后女性高血压患者血压水平与雌激素、
糖化血红蛋白的相关性[J].中华高血压杂志,2014,22(10)：974-976.
相似文献/References:
[1]潘文超,赵蓓.上气道咳嗽综合征200例中医证型观察[J].中国中医药信息杂志,2010,17(6):22.[doi:10.3969/j.issn.1005-5304.2010.06.010]
PAN Wen-chao,ZHAO Pei.Observation of TCM Syndromes of 200 Cases of Upper Airway Cough Syndrome[J].zhongguo zhongyiyao xinxi zazhi,2010,17(4):22.[doi:10.3969/j.issn.1005-5304.2010.06.010]
[2]洪军,赵明芬,汪建萍,等.新疆522例高脂血症住院患者中医证型研究[J].中国中医药信息杂志,2010,17(8):11.[doi:10.3969/j.issn.1005-5304.2010.08.006]
HONG Jun,ZHAO Ming-fen,WANG Jian-ping,et al.Study on TCM Syndromes of 522 Patients with Hyperlipemia in Xinjiang[J].zhongguo zhongyiyao xinxi zazhi,2010,17(4):11.[doi:10.3969/j.issn.1005-5304.2010.08.006]
[3]李荣,陈海生.慢性心力衰竭患者左室射血分数和B型利钠肽与中医证型的相关性研究[J].中国中医药信息杂志,2010,17(8):13.[doi:10.3969/j.issn.1005-5304.2010.08.007]
LI Rong,CHEN Hai-sheng.Study on the Relationship among LVEF, BNP and TCM Syndrome of Patients with Chronic Heart Failure[J].zhongguo zhongyiyao xinxi zazhi,2010,17(4):13.[doi:10.3969/j.issn.1005-5304.2010.08.007]
[4]张广德,邹本良,刘蕊,等.2型糖尿病周围神经病变中医证型与危险因素相关性分析[J].中国中医药信息杂志,2010,17(8):17.[doi:10.3969/j.issn.1005-5304.2010.08.009]
ZHANG Guang-de,ZOU Ben-liang,LIU Rui,et al.Research on Relativity between Risk Factors and TCM Syndrome Types of Type 2 Diabetes Mellitus Peripherial Neuropathy[J].zhongguo zhongyiyao xinxi zazhi,2010,17(4):17.[doi:10.3969/j.issn.1005-5304.2010.08.009]
[5]叶敏,指导：魏品康.魏品康从痰论治高血压病经验总结[J].中国中医药信息杂志,2011,18(2):95.[doi:10.3969/j.issn.1005-5304.2011.02.049]
[J].zhongguo zhongyiyao xinxi zazhi,2011,18(4):95.[doi:10.3969/j.issn.1005-5304.2011.02.049]
[6]刘莉,邓晓威,张雪松,等.代谢综合征常见中医证型与高敏C反应蛋白及颈动脉内中膜厚度的相关研究[J].中国中医药信息杂志,2009,16(3):22.
LIU Li,DENG Xiao-wei,ZHANG Xue-song,et al.Research on the Relationship between CRP, IMT and TCM Syndrome Types of MS[J].zhongguo zhongyiyao xinxi zazhi,2009,16(4):22.
[7]万启南,张玉,张立群,等.化痰活血平压汤治疗老年人高血压60例疗效观察[J].中国中医药信息杂志,2009,16(5):76.
[J].zhongguo zhongyiyao xinxi zazhi,2009,16(4):76.
[8]杨国旺,富琦,徐咏梅,等.晚期非小细胞肺癌患者凝血指标的临床分析[J].中国中医药信息杂志,2009,16(6):19.
YANG Guo-wang,FU Qi,XU Yong-mei,et al.Clinical Analysis on Coagulation Markers in Advanced NSCLC Patients[J].zhongguo zhongyiyao xinxi zazhi,2009,16(4):19.
[9]杨海燕,金艳蓉,杨红.糖尿病合并高血压的中医治疗思路与方法[J].中国中医药信息杂志,2007,14(1):87.
[J].zhongguo zhongyiyao xinxi zazhi,2007,14(4):87.
[10]张春燕,李宗信,黄小波,等.老年颈动脉硬化患者血清炎症因子与中医证型的关系[J].中国中医药信息杂志,2009,16(7):19.
ZHANG Chun-yan,LI Zong-xin,HUANG Xiao-bo,et al.Research of Serum Inflammatory Factors in Aged Carotid Artery Atherosclerosis Patients with Different Chinese Medicine Syndromes[J].zhongguo zhongyiyao xinxi zazhi,2009,16(4):19.
[11]陈金水,吴天敏,范柳芳,等.高血压合并颈动脉硬化中医证型与颈动脉斑块及脂联素水平的相关性研究[J].中国中医药信息杂志,2013,20(8):21.[doi:10.3969/j.issn.1005-5304.2013.08.008]
[J].zhongguo zhongyiyao xinxi zazhi,2013,20(4):21.[doi:10.3969/j.issn.1005-5304.2013.08.008]
[12]鲁成,宋磊,刘永明.443例原发性高血压中医证型分布及血压变异性规律研究[J].中国中医药信息杂志,2017,24(7):19.[doi:10.3969/j.issn.1005-5304.2017.07.005]
LU Cheng,SONG Lei,LIU Yong-ming.Study on TCM Syndrome Distribution and Blood Pressure Variability in 443 Patients with Primary Hypertension[J].zhongguo zhongyiyao xinxi zazhi,2017,24(4):19.[doi:10.3969/j.issn.1005-5304.2017.07.005]
[13]刘志军,金华,苏莉莉,等.不同中医证型高血压患者心率变异性及其影响因素分析[J].中国中医药信息杂志,2017,24(9):15.[doi:10.3969/j.issn.1005-5304.2017.09.005]
LIU Zhi-jun,JIN Hua,SU Li-li,et al.Analysis on Heart Rate Variability and Its Influencing Factors of Hypertensive Patients from Different TCM Syndrome[J].zhongguo zhongyiyao xinxi zazhi,2017,24(4):15.[doi:10.3969/j.issn.1005-5304.2017.09.005]
备注/Memo
基金项目：甘肃省中医药管理局科研项目（GZK-2013-41）；甘肃省高等学校科学研究创新团队项目（2017C-14）
更新日期/Last Update:
2018-03-15