近20年高血压病相关中医证候特征研究的文献分析  

Literature Analysis of Studies on TCM Syndromes of Hypertension in Recent 20 Years

作　　者：朱灵妍[1] 姚成增[1] 韩栋[2] 蒋梅先[1] 王龙[1] 

机构地区：[1]上海中医药大学附属曙光医院心内科,上海200021 [2]滕州市中心人民医院中医科,山东滕州277500

出　　处：《中华中医药学刊》2014年第4期788-790,共3页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81273959);上海市卫生系统优秀青年人才培养计划项目(XYQ2011064);海派中医流派传承研究基地建设项目--丁氏内科流派张伯臾临床传承研究基地(ZYSNXD-CC-HPGC-JD-003);上海市科委项目(12401901402);上海市中西医结合重点病种建设项目(zxbz2012-08)

摘　　要：目的:从高血压中医证候类型、证候因素,地域及时间变迁及老年高血压的角度,对近20年间国内高血压病相关辨证分型的文献进行分析研究。方法:对1993—2013年中国期刊全文数据库(CNKI)及中国生物医学文献数据库(CBM)收录的高血压中医证候特征相关文献进行全面检索,对其中医证型,证候因素,不同时期不同地域的变化规律及老年高血压的证候特征进行统计分析。结果:纳入文献137篇,病例43626例,覆盖全国24个省市地区,证候类型常见的有阴虚阳亢、痰湿壅盛、肝火亢盛、阴阳两虚、肝阳上亢、肝肾阴虚、瘀血阻窍证,老年高血压阴阳两虚证的比例明显上升,证候因素以阴虚、阳亢、痰、火、阳虚、血瘀多见。近年来肝阳上亢证、瘀血阻窍证的患者显著增加,实性证候因素所占比例也不同程度的升高。东北地区阴虚阳亢、肝火亢盛及阴阳两虚证证型所占比例明显高于其他地区,华北地区则以痰湿壅盛证居多,瘀血阻窍证型西北地区占首位,肝肾阴虚证、肝阳上亢证分别以华中、西南地区最多。结论:高血压病机以本虚标实多见,本虚以阴虚、阳虚为主,标实以阳亢、痰、火多见,近年来血瘀等实性证候因素在高血压证候中所占比例有所提高。Objective ： To analyse the related literature in nearly 20 years from the point of TCM syndromes of hyperten- sion, syndrome factors, changing law in different region and period of time and hypertension in the elderly. Methods ： A comprehensive search of the TCM syndrome characteristics of hypertension published in CNKi and CBM from 1993 to 2013 was carried out. Above- mentioned TCM syndrome characteristics were analyzed. Results：Totally 137 articles were enrolled and 43626 cases were analyzed, covering 24 regions. The common TCM syndromes of hypertension were yin defi- ciency and yang hyperactivity, exuberance of phlegm and dampness , hyperactivity of liver fire, deficiency of both yin and yang, hyperactivity of liver yang, yin deficiency of liver and kidney, blood stasis blocking. The proportion of deficiency of both yin and yang in hypertension in elderly was increased significantly. The related syndrome factors were yin deficiency, yang hyperactivity, dampness, fire, yang deficiency and blood stasis. There was a significant increase in hyperactivity of liv- er yang and blood stasis blocking in recent years ,as well as symptom excess type of syndrome factors. The TCM syndromes of yin deficiency and yang hyperactivity, hyperactivity of liver fire and deficiency of both yin and yang were the first in Northeast. Exuberance of phlegm and dampness was most in North China, blood stasis blocking was the first in Northwest, yin deficiency of liver and kidney, hyperactivity of liver yang were the first in central and southwest regions respectively. Conclusion ： The root deficiency type of hypertension was mainly of yin deficiency and yang deficiency, the symptom excess type was mainly of yang hyperactivity, phlegm and fire. The proportion of syndrome factors of symptom excess type like blood stasis was increased in recent years.

关 键 词：高血压 证候 证候因素 文献分析 

分 类 号：R544.1[医药卫生—心血管疾病]