原发性高血压病患者并发血管危险事件与中医证候的相关性研究  

Correlation between complication of vascular risk event and TCM syndrome in patients with essential hypertension

作　　者：吴爱明[1] 张冬梅[1] 翟建英[2] 高永红[1] 朱海燕[3] 赵明镜[1] 李本志[1] 王硕仁[1] 

机构地区：[1]北京中医药大学东直门医院中医内科学教育部和北京市重点实验室,北京100700 [2]中药复方新药开发国家工程研究中心,北京100079 [3]北京中医药大学心血管病研究所,北京100700

出　　处：《北京中医药》2013年第4期248-251,共4页Beijing Journal of Traditional Chinese Medicine

基　　金：国家重点基础研究发展计划(973计划)资助项目(2006CB504805);北京市教委科研基地资助项目(北京中医药大学2012)

摘　　要：目的研究中医证候与原发性高血压病患者并发心脑血管危险事件的相关性。方法收集397例原发性高血压病患者的临床资料,比较并发心脑血管危险事件(有事件组)和未并发心脑血管危险事件(无事件组)患者的中医证候差异,分析中医证候与并发血管危险事件的相关性。结果有事件组的风证和痰证的发生率高于无事件组(P<0.01),虚证的发生率低于无事件组(P<0.01)。在中医证候相兼方面,无事件组多无证候相兼,有事件组多出现两证或多证相兼(P<0.01)。血管危险事件与风证、痰证和证候相兼情况之间呈正相关(r值分别为0.214、0.445、0.263,P<0.01),与虚证呈负相关(r=-0.148,P<0.01)。逐步Logistic回归分析显示,痰证、性别、年龄和风证与血管危险事件的关系最为密切。痰证、男性、高龄和风证患者并发血管危险事件的风险分别增加10.626、3.147、2.771和2.105倍(P<0.01或P<0.05)。结论从中医证候入手可以评估原发性高血压病患者发生心脑血管危险事件的风险。在瘀证基础上兼夹痰证和风证是心脑血管危险事件发生的特征性中医证候改变。Objective To explore the correlation between TCM syndrome and complication of cardio-cerebrovascular risk event in patients with essential hypertension. Methods Three hundred and ninety seven clinical cases of essential hypertension were collected. TCM syndrome differences between patients with and without complication of cardio-cerebrovascular risk event （event group and non-event group） were compared, and the correlation of TCM syndrome and complication of vascular risk event was analyzed. Results The incidence of wind syndrome and phlegm syndrome in the event group was higher than that in the non-event group （P 〈 0.01）, while the incidence of deficiency syndrome lower （P 〈 0.01）. As for TCM accompanied syndromes, there were mostly no accompanied syndromes in the non-event group while two or more in the event group （ P 〈0.01）. The vascular risk event was positively correlated with wind syndrome, phlegm syndrome and TCM accompanied syndrome （r=0.214, 0.445, 0.263, respectively, P 〈 0.01）; and negatively correlated with deficiency syndrome （r= - 0.148, P 〈 0.01）. It was showed that phlegm syndrome, gender, age and wind syndrome were most closely linked to vascular risk event by stepwise Logistic regression analysis. The complication risk of the vascular risk event increased by 10.626, 3.147, 2.771 and 2.105 times in patients with phlegm syndrome, male, aged and wind syndrome, respectively （P 〈 0.01 or P 〈 0.05）. Conclusion It is feasible to evaluate the risk of cardio-cerebrovascular event in patients with essential hypertension from TCM syndromes. The stasis syndrome combined with phlegm and/or wind syndrome is the characteristic TCM syndrome change in eardio-cerebrovaseular risk event.

关 键 词：中医证候 高血压 危险事件 二级预防 

分 类 号：R259[医药卫生—中西医结合]