高血压病中医证型与动态血压相关性研究  

Association Study Between Traditional Chinese Medicine Syndrome Types and Ambulatory Blood Pressure in Patients with Hypertension

作　　者：宋磊[1] 刘永明[1] 鲁成[1] 王肖龙[1] 邵春林[1] 龚菊芬[1] 吴昉怡[1] 王慧颖[1] 

机构地区：[1]上海中医药大学附属曙光医院心内科,上海201203

出　　处：《四川中医》2015年第1期61-65,共5页Journal of Sichuan of Traditional Chinese Medicine

基　　金：国家自然科学基金项目资助(编号:81102671);上海市高级中西医结合人才培养项目资助(编号:ZYSNXD012-RC ZXY002);上海市卫生局项目资助(编号:20114044);上海市中医临床重点实验室资助(编号:C10dz2220200)

摘　　要：目的:初步探索上海地区不同高血压病中医证型与动态血压的相关性。方法:按纳入标准选择原发性高血压病患者107例,收集中医四诊信息及动态血压报告,对其进行辨证分型并比较不同证型组的动态血压特点。结果:(1)高血压各证型分布比例从高到低依次为:肝肾阴虚证>肝阳上亢证>阳气虚衰证>气阴两虚证>痰湿壅盛证(32.71%VS 19.63%VS 18.69%VS 15.89%VS 13.08%)。(2)124小时动态血压各期血压比较研究:痰湿壅盛证24h SBP、24h DBP、日间SBP、日间DBP、夜间SBP、夜间DBP的血压均值高于其他证型;其中,痰湿壅盛证的日间DBP高于肝肾阴虚证、阳气虚衰证(P<0.05),具统计学意义;痰湿壅盛证、肝肾阴虚证的夜间SBP高于肝阳上亢证(P<0.05),具统计学意义。2血压变异性比较研究:高血压不同证型组24小时SBP-SD、日间SBP-SD、夜间DBP-SD肝肾阴虚证最高,24小时DBP-SD、日间DBP-SD气阴两虚证最高,夜间SBP-SD痰湿壅盛证最高;其中,肝肾阴虚证夜间DBP-SD高于肝阳上亢证(P<0.05),具统计学意义。3血压负荷值比较研究:痰湿壅盛证组24小时SBP、24h DBP、日间SBP、日间DBP、夜间SBP、夜间DBP的血压负荷值均高于其他证型;其中,痰湿壅盛证24小时DBP负荷值高于肝肾阴虚证、肝阳上亢证(P<0.05),具统计学意义;痰湿壅盛证日间DBP负荷值高于肝肾阴虚证、肝阳上亢证、阳气虚衰证(P<0.05),具统计学意义;痰湿壅盛证夜间SBP负荷值、夜间DBP负荷值高于肝阳上亢证(P<0.05),具统计学意义。4昼夜节律比较研究:高血压不同中医证型昼夜节律异常频数肝肾阴虚证与痰湿壅盛证高于其他各证型组;5晨峰血压比较研究:高血压不同中医证型晨峰血压比例肝阳上亢证高于其他各证型组。结论:该研究利用动态血压进行高血压中医证型研究,结果显示肝肾阴虚证在高血压患者中所占比重最高;痰湿壅盛证各期血压均值最高,各期血压负荷值最大;�Objective： To study the correlation between TCM syndrome types and ambulatory blood pressure of patients with hypertension in Shanghai. Methods： According to the inclusion criteria,107 patients with essential hypertension were selected.TCM diagnostic information and results of ambulatory blood pressure were collected,and the relationship between patient’s TCM Syndrome Types and characteristics of ambulatory blood pressure were studied. Results：（ 1） TCM syndrome types distributions from highest to lowest in hypertension were： liver- kidney Yin deficiency（ LKYD） 〉 liver- Yang hyperactivity（ LYH） 〉Yang deficiency（ YD） 〉 both Qi and Yin deficiency（ BQYD） 〉 excess accumulation of phlegm- dampness（ EAPD）（ 32. 71% VS 19. 63% VS 18. 69% VS 15. 89% VS 13. 08%）.（ 2） 1Comparison on blood pressure value of ambulatory blood pressure： the blood pressure value of EAPD syndrome was highest in 24 hS BP /24 h DBP / daytime SBP / daytime DBP / nighttime SBP / nighttime DBP. In comparison of daytime DBP,the blood pressure value of EAPD syndrome was statistically higher than LKYD syndrome and YD syndrome（ P 〈 0. 05）. 2Comparison on blood pressure variability： the blood pressure variability of LKYD syndrome was highest in 24 hS BP- SD / daytime SBP- SD / nighttime DBP- SD; the blood pressure variability of BQYD syndrome was highest in 24 hD BP- SD / daytime DBP- SD; the blood pressure variability of EAPD syndrome was highest in nighttime SBP- SD. In comparison of nighttime DBP- SD,the blood pressure variability of LKYD syndrome was statistically higher than LYH syndrome（ P 〈 0. 05）. 3Comparison of blood pressure load： the loading value of EAPD syndrome was highest in24 hS BP,24 hD BP,SBP / daytime,DBP / daytime,SBP / nighttime,DBP / nighttime. In comparison of 24 hD BP,the loading value of EAPD syndrome was statistically higher than LKYD syndrome and LYH syndrome（ P 〈 0. 05）; in comparison of daytime DBP,the loading value of EAPD syndrome was statistically highe

关 键 词：高血压病 中医证型 动态血压 血压变异性 血压负荷值 昼夜节律 晨峰血压 

分 类 号：R544.1[医药卫生—心血管疾病]