老年女性原发性高血压病患者睡眠时长与骨质疏松症及肾阴虚证的相关分析  

Relationship Among Sleep Duration and Osteoporosis and Shen Yin Deficiency Syndrome in Elderly Women with Essential Hypertension

作　　者：孟晓嵘 高原[3,4] 黄昉萌 曾辉[3,4] 骆杰伟 魏世超[2,3] 郑星宇[2,3] MENG Xiao-rong;GAO Yuan;HUANG Fang-meng;ZENG Hui;LUO Jie-wei;WEI Shi-chao;ZHENG Xing-yu(Department of Traditional Chinese Medicine,Aviation General Hospital of China Medical University,Beijing 100012;Provincial Clinical Medical College,Fujian Medical University,Fuzhou 350001;Department of Tradi-tional Chinese Medicine,Fujian provincial hospital,Fuzhou 350001;The Second,Fujian University of Traditional Chinese Medicine,Fuzhou 350001)

机构地区：[1]中国医科大学航空总医院中医科,北京100012 [2]福建医科大学省立临床医学院,福州350001 [3]福建省立医院中医科,福州350001 [4]福建中医药大学第二临床医学院,福州350001

出　　处：《中国中西医结合杂志》2018年第10期1197-1202,共6页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：福建省中医药科研项目计划(No.2017FJZYJC105);福建省卫生系统中青年骨干人才培养项目资助计划(No.2015-ZQN-ZD-7)

摘　　要：目的探讨老年女性原发性高血压(EH)患者的夜间睡眠时长、午睡时长与骨质疏松症(OP)、肾阴虚证的关系。方法选择老年女性EH患者394例,其中肾阴虚证患者192例,非肾阴虚证患者202例,OP患者196例,非OP患者198例。通过问卷调查睡眠时长,回顾性研究老年女性EH患者夜间睡眠时长(夜间睡眠时长<6 h/d、6~8 h/d、>8 h/d)及午睡时长(午睡时长<30 min/d、30~60 min/d、>60 min/d)与OP及肾阴虚证的关系。用双能X线骨密度仪测骨密度(BMD,包括腰椎L2~L4、大转子、股骨颈、Ward's三角区)及计算腰椎、左侧髋关节骨密度T值。采用Logistic回归分析OP与睡眠时长、BMI及尿酸(UA)的相关性。结果与OP患者比较,非OP患者股骨颈、Ward's三角区、大转子、腰椎L2~L4 BMD,及左侧髋关节T值及腰椎T值升高(P <0. 01)。OP患者中夜间睡眠时长6~8 h/d比例低于<6 h/d、>8 h/d比例(分割χ2=28. 41,P <0. 01)。OP患者中午睡时长<30 min/d比例低于30~60 min/d和> 60 min/天比例(分割χ2=28. 08,P <0. 01)。患OP风险与夜间睡眠时长<6 h/d和> 8 h/d及午睡时长≥30 min/d呈正相关(OR值分别为4. 198及3. 160,均P <0. 01)。另外患OP风险与BMI及UA值呈负相关(OR值分别为0. 879,0. 996,均P <0. 01)。与非肾阴虚证患者比较,肾阴虚患者股骨颈、Ward's三角区、大转子、腰椎L2~L4 BMD及左侧髋关节T值、腰椎T值下降(P <0. 01)。肾阴虚证患者午睡时长中位数30 (0~87. 50) min高于非肾阴虚证患者15(0~60)min(P <0. 01)。肾阴虚与非肾阴虚患者的夜间、午睡眠时长分布比较差异有统计学意义(P <0. 01),夜间睡眠时长6~8 h/d肾阴虚证患者比例低于<6 h/d和> 8 h/d(分割χ2=14. 49,P <0. 01)。午睡时长<30min/d肾阴虚证患者比例低于30~60 min/d和> 60 min//d(分割χ2=17. 09,P <0. 01)。结论夜间、午睡眠时长、高血压水平可能是老年女性EH患者患OP的危险因素,肾阴虚可能是老年女性EH患者OP的主要病机。Objective To explore the relationship among nocturnal sleep duration,daytime napping and osteoporosis（ OP） and Shen yin deficiency syndrome in elderly women with essential hypertension（ EH）. Methods Totally 394 elderly EH patients were selected in this study,including 192 cases with Shen yin deficiency syndrome,202 with non-Shen yin deficiency syndrome,196 cases with OP,and 198 cases with non-OP. The length ofsleep was investigated through a questionnaire,and retrospectively study the relationship among the length of nocturnal sleep duration in elderly women with EH（ nocturnal sleep duration 〈6 h/d,6-8 h/d, 〉8 h/d）,daytime napping（ daytime napping 〈30 min/d,30-60 min/d,〉60 min/day）,OP and Shen yin deficiency syndrome. Bone mineral density（ BMD） was measured by dual-energy X-ray absorptiometry [ lumbar vertebra L2-L4,greater trochanter,femoral neck,Ward＇s triangle]and the bone density T value of lumbar vertebrae and left hip joint was calculated. Logistic regression was used to analyze the correlation between OP and sleep duration,BMI and uric acid（ UA）.Results Compared with OP patients,non-OP patients＇ femoral neck,Ward＇ s triangle,greater trochanter,lumbar vertebrae L2-L4 BMD,left hip T value and lumbar T value were increased（ P〈0. 01）.The proportion of nocturnal sleep duration of 6-8 h/d in patients with OP was lower than those nocturnal sleep duration 〈6 h/d and 〉8 h/d（ segment χ2= 28. 41,P〈0. 01）. The proportion of patients with OP at daytime napping 〈30 min/d was lower than 30-60 min/d and 〉60 min/d（ segment χ2= 28. 08,P〈0. 01）. The risk of patients with OP was positively correlated with nocturnal sleep duration 6 h/d and 8 h/d and daytime napping≥30 min/d（ OR values respectively were 4. 198 and 3. 160,P〈0. 01）. In addition,the risk of patients with OP was negatively correlated with BMI and UA values（ OR values respectively were 0. 879,0. 996,P〈0. 01）. Compared with non-Shen yin deficiency syndrome,Shen yin deficiency syndrome pa

关 键 词：老年女性 原发性高血压病 睡眠时长 骨质疏松症 肾阴虚证 

分 类 号：R259[医药卫生—中西医结合]