高血压病患者摄盐量与中医证型及动态血压特征相关性的临床研究  

Clinical study on the relationship between salt intake and TCM syndromes and characteristics of ambulatory blood pressure in patients with hypertension

作　　者：白嘉玥 顾宁[2] BAl Jia-yue;GU Ning(Nanjing Hospital of Traditional Chinese Medicine,Nanjing 210022,China)

机构地区：[1]南京市中医院,南京210022 [2]南京市中医院心血管科,南京210022

出　　处：《中华中医药杂志》2021年第1期573-577,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：第二批江苏省中医药领军人才培养项目(No.苏中医科教[2018]4号);南京市名中医专家工作室建设项目(No.宁卫中医[2017]8号);南京市中医药转化医学基地项目(No.市中医科字[2014]5号)。

摘　　要：目的:研究高血压病患者不同中医证型间的摄盐量的差异,及摄盐量与动态血压各项检测指标的相关性。方法:纳入高血压病患者90例,中医辨证分为肝阳上亢(26例)、瘀血阻络(15例)、痰湿壅盛(22例)、肾精亏损证(27例)4型,检测记录一般情况、就诊血压、盐阈值、24h动态血压等,部分患者测定24h尿钠浓度。结果:肾精亏损证患者的年龄较其他3个证型患者偏高;不同盐阈值的患者口味咸淡自评存在差异,盐阈值与24h尿钠浓度呈正相关;各证型患者摄盐量从大到小排序为:肾精亏损>肝阳上亢>瘀血阻络>痰湿壅盛;患者盐阈值与24h平均血压值呈正相关,与血压变异性、血压昼夜节律近似无关。结论:肾精亏损证高血压病患者的摄盐量处于较高水平,符合"咸入肾"的中医理论;摄盐量高的患者血压升高更加显著,高血压病患者的限盐膳食十分必要。Objective:To observe the difference in salt intake between different traditional Chinese medicine(TCM)syndrome types of hypertensive patients,and the correlation between salt intake and ambulatory blood pressure indicators.Methods:Ninety cases of hypertensive patients were divided into 4 TCM syndrome types including syndrome of upper hyperactivity of liver yang(26 cases),syndrome of static blood blocking collaterals(15 cases),syndrome of internal exuberance of phlegm-damp(22 cases),syndrome of kidney deficiency(27 cases).All patients underwent general investigation,blood pressure measurement,salt threshold test,and 24 h ambulatory blood pressure monitoring.Some patients measured 24 h sodium concentration.Results:The age of patients with kidney deficiency syndrome was higher than that of the other 3 groups.There was a statistical difference in taste self-assessment between patients with different salt thresholds.The salt threshold was positively correlated with 24 h sodium concentration.The trend of salt intake in each group was evaluated as kidney deficiency>upper hyperactivity of liver yang>syndrome of static blood blocking collaterals>syndrome of internal exuberance of phlegm-damp.The salt threshold was positively correlated with 24 h mean blood pressure,but irrelevant to blood pressure variability and circadian rhythm.Conclusion:Salt intake of patients with kidney deficiency syndrome is at a high level,corresponding to the TCM theory of’salt into kidney’.High salt intake leads to high blood pressure,so the salt-limited diet of hypertensive patients is necessary.

关 键 词：高血压病 摄盐量 中医证型 相关性 

分 类 号：R259[医药卫生—中西医结合]