社区正常高值血压人群中医证候流行病学调查  

Epidemiological Investigation on TCM Patterns of High-Normal Blood Pressure Population in Functional Communities

作　　者：杨传华[1,2,3] 陆峰[1,2,3] 袁杰 刘杨[1] 董小康[1] 李磊 赵恒懿[1] 武昊鹏[1] 刁书剑[4] 范晓艳[4] 杨洁[1] 陈兴娟[4] 陈健[5] 李成伟 刘松虎[4] 高琛琛 刘南南 巩伟玲[4] 吕璐[4] 高红梅[9] 李晓娟[10] 李东娜[1] 陈文静 王震[1] 刘悦[11] 丁铭 田颖 

机构地区：[1]山东中医药大学附属医院,山东省济南市文化西路42号250011 [2]国家中医药管理局高血压病血脉理论及应用重点研究室 [3]高血压国家中医临床研究基地 [4]山东中医药大学 [5]济南市中心医院 [6]德州市中医院 [7]淄博市第一医院 [8]淄博市张店区中医院 [9]中国人民武装警察部队山东省总队医院 [10]德州市人民医院 [11]淄博市中医医院 [12]菏泽市中医医院

出　　处：《中医杂志》2013年第19期1666-1671,共6页Journal of Traditional Chinese Medicine

基　　金："十一五"国家科技支撑计划资助项目(2007BAI20B071);国家中医药行业科研专项资助项目(201007003-01);山东省"泰山学者"建设工程专项经费资助项目

摘　　要：目的初步探讨社区正常高值血压人群中医证候分布规律。方法对山东省德州市平原县教育局机关和全县108所中小学校全体在职和离退休人员进行现场调查,采用标准证候调查问卷,收集受试者性别、年龄、体重指数、腰臀围比值、血压、心率、合并危险因素等基线资料,归纳受试者中医证候分布情况。结果 3 860例受试者中共检出正常高值血压1 050例,检出率为27.4%,男性高于女性(P<0.05)。正常高值血压者的危险因素为性别、教育程度、饮酒、血脂异常病史和体重指数。正常高值血压单一证候的比例较高,且伴随年龄增长出现差异(P<0.01),即50岁前以肝火亢盛证为主,60岁后以阴虚阳亢证和阴阳两虚证为主;阴虚阳亢证及肝火亢盛证的影响因素均为性别。正常高值血压者在各年龄段的肾虚证和非肾虚证差异明显(P<0.01),即50岁以前以非肾虚证为主,60岁以后以肾虚证为主;肾虚证的影响因素主要为年龄。结论社区正常高值血压人群以肝火亢盛、阴虚阳亢等肝系证候为基本证候,伴随年龄增长,特别是男性,可能逐渐呈现由实证(肝火亢盛)到虚实夹杂证(阴虚阳亢),最后发展为虚证(肾虚或阴阳两虚)的动态演变规律。Objective To research the TCM pattern distribution of high-normal blood pressure population in communities. Methods All employees and retirees from education authorities and 108 primary and secondary schools in Pingyuan County, Dezhou City, Shandong Province were investigated. The standard pattern questionnaire was used to collect the gender, age, body mass index （BMI）, waist hip ratio （WHR）, blood pressure, heart rate and combined risk factors. The TCM pattern distribution of the subjects was analyzed. Results There were 1050 cases （27.4~） of high-normal blood pressure were found in totally 3860 subjects and the detection rate of the male was higher than that of the female （P〈0.05）. The risk factors of high-normal blood pressure were gender, education level, alcohol consumption, history of dyslipidemia and BMI. The proportion of single pattern in high-normal blood pressure population was high and difference occurred with age growth （P〈0.01）. Liverfire exuberance pattern was common in people under 50 years old. Yin deficiency yang hyperactivity pattern and yin-yang defi- ciency pattern was common in people over 60 years old. The influencing factors of yin deficiency yang hyperactivity pattern and liver fire exuberance pattern were gender. There were significant differences between the kidney deficiency pattern and non kid- ney deficiency pattern in people with high-normal blood pressure of all ages （P（O. 01）. Non kidney deficiency pattern was common in people under 50 years old. Kidney deficiency pattern was common in people over 60 years old. The influencing fac- tor of kidney deficiency pattern was age. Conclusion The basic patterns of high-normal blood pressure population in communi- ties are liver fire exuberance pattern and yin deficiency yang hyperactivity pattern. The TCM patterns may change from reple- tion pattern （liver fire exuberance） to deficiency-repletion complex pattern （yin deficiency yang hyperactivity） and finally devel- op into deficiency pattern （kidney

关 键 词：血压 正常高值血压 中医证候 流行病学调查 分布规律 

分 类 号：R259[医药卫生—中西医结合]