原发性高血压患者358例心血管危险分层与中医问诊症状的相关性分析  

Correlation analysis between cardiovascular risk stratification and TCM interrogation symptoms in 358 patients with essential hypertension

作　　者：解天骁 赵倩倩 张梦楚 李媛媛 徐璡 郭睿[1] 王忆勤[1] 燕海霞[1] XIE Tian-xiao;ZHAO Qian-qian;ZHANG Meng-chu;LI Yuan-yuan;XU Jin;GUO Rui;WANG Yi-qin;YAN Hai-xia(Shanghai Key Laboratory of Health Identification and Assessment,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学上海市健康辨识与评估重点实验室,上海201203

出　　处：《中华中医药杂志》2022年第8期4774-4778,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.81973749,No.81473594)。

摘　　要：目的:探讨原发性高血压危险分层与中医问诊症状的相关性,为原发性高血压患者心血管风险事件预警提供依据。方法:采集原发性高血压患者358例,按高血压心血管危险分层分为低中危组(36例)、高危组(111例)、很高危组(211例),采集现在症状、既往史、生活史等信息,采用系统聚类分析和多元有序Logistic回归分析方法,探讨原发性高血压心血管危险分层与中医问诊症状的相关性。结果:很高危组的平均病程显著长于低中危组和高危组(P<0.05)。频次前10的问诊症状中,头晕、口渴、腰膝酸软、胸闷、心悸/怔忡、乏力懒言是3组的共有症状。头晕、发白/早脱、畏热、关节痛与原发性高血压患者心血管危险分层有一定相关性。结论:病程是原发性高血压患者心血管危险分层的影响因素之一,高血压患者不同心血管危险分层组问诊症状总体相似,但低中危组中实证症状较多,很高危组则是虚证症状为主,中医问诊对高血压心血管危险分层的辨识有较高价值。Objective:To explore the correlation between risk stratification of essential hypertension and symptoms of traditional Chinese medicine,and to provide basis for early warning of cardiovascular risk events in patients with essential hypertension.Methods:A total of 358 patients with essential hypertension were collected and divided into low and medium risk group(36 cases),high-risk group(111 cases) and very high-risk group(211 cases) according to the cardiovascular risk stratification of hypertension.The current symptoms,past history,life history and other information were collected.The correlation between cardiovascular risk stratification of essential hypertension and symptoms of traditional Chinese medicine was explored by systematic cluster analysis and multiple ordered Logistic regression analysis.Results:The average course of disease in the very high-risk group was significantly longer than that in the low,medium and high-risk groups(P<0.05).Dizziness,thirst,weakness of the waist and knees,chest tightness,cardiopalmus/severe palpitation,fatigue and laziness were the common symptoms of the three groups.Dizziness,hoarseness/premature prolapse,fear of heat and joint pain are related to cardiovascular risk stratification in patients with essential hypertension.Conclusion:the course of disease is one of the influencing factors of cardiovascular risk stratification in patients with essential hypertension.The symptoms of hypertension patients in different cardiovascular risk stratification groups are generally similar,but the positive symptoms are more in the low and medium risk group,and the deficiency symptoms are the main symptoms in the very high-risk group.Traditional Chinese medicine has high value in identifying cardiovascular risk stratification of hypertension.

关 键 词：原发性高血压 危险分层 中医问诊 聚类分析 多元有序Logistic回归分析 

分 类 号：R259[医药卫生—中西医结合]