神经源性直立性低血压合并卧位高血压中医证候要素特征研究  

Study on TCM syndrome elements characteristics of neurogenic orthostatic hypotension combined with supine hypertension

作　　者：王倩[1] 张春燕[1] 陈玉静[1] 王宏[1] 孙亚男[1] 王建东[1] 黄小波[1] WANG Qian;ZHANG Chun-yan;CHEN Yu-jing;WANG Hong;SUN Ya-nan;WANG Jian-dong;HUANG Xiao-bo(Department of Traditional Chinese Medicine,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院中医科,北京100053

出　　处：《北京中医药》2022年第8期903-906,共4页Beijing Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(81574036);北京市自然科学基金资助项目(7172094);北京市中医药科技发展资金资助项目(JJ-2020-66)。

摘　　要：目的探讨神经源性直立性低血压(nOH)合并卧位高血压(SH)患者的中医证候要素特征。方法选择nOH患者160例,根据是否合并SH分为nOH组82例,nOH+SH组78例。采用中医证候要素评分表对2组患者进行评分比较,并就各证候要素对伴发SH的危险度进行分析。结果证候要素分布方面,2组病位要素均为脑、脾、肾、肝,组间差异均无统计学意义(P>0.05);病性要素中,2组出现频率均较高的证素为气虚、髓减、肝风、痰浊证,nOH+SH组痰浊证、瘀血证所占比例均高于nOH组(P<0.05),并以瘀血证更为显著(P<0.05)。证候要素积分方面,nOH+SH组痰浊证、瘀血证、肝风证评分均高于nOH组(P<0.05),并以痰浊证、瘀血证更为显著(P<0.01)。Logistic回归分析显示,证候要素髓减证、痰浊证、瘀血证与SH发生存在相关性(P<0.05),其OR值分别为0.037、8.504、12.721。结论nOH合并SH患者病位要素以脑为主,并与脾、肾、肝密切相关;病性要素以气虚证、髓减证、肝风证、痰浊证、瘀血证为主;痰浊证、瘀血证可能是nOH患者伴发SH的危险因素。Objective To explore TCM syndrome elements characteristics in patients with neurogenic orthostatic hypotension(nOH)combined with supine hypertension(SH).Methods 160 patients with nOH were enrolled,and were divided into nOH group(82 cases)and nOH+SH group(78 cases)according to whether they were complicated with SH or not.The two groups of patients were scored by TCM syndrome element scoring table to make comparison,and the risks of each syndrome element to SH was analyzed.Results In terms of the distribution of syndrome elements,the disease location elements of the two groups were brain,spleen,kidney and liver,and there was no significant difference between the two groups(P>0.05).Among the disease nature,the syndrome elements with higher frequency were qi deficiency,myelopathy,liver wind and phlegm turbidity syndrome in both two groups.The proportion of phlegm turbidity syndrome and blood stasis syndrome in nOH+SH group was higher than that in nOH group(P<0.05),and blood stasis syndrome was more significant(P<0.05).Syndrome factor integral,the scores of phlegm turbid syndrome,blood stasis syndrome,liver wind syndrome scores in nOH+SH group were higher than those in nOH group(P<0.05),and phlegm turbid syndrome,blood stasis syndrome was more significant(P<0.01).Logistic regression analysis showed that the syndrome elements of myelopathy syndrome,phlegm turbid syndrome,blood stasis syndrome and the occurrence of SH were related(P<0.05),the OR values were 0.037,8.504 and 12.721 respectively.Conclusion Brain is the main location element in patients with nOH combined with SH,and but the spleen,kidney and liver are also involved.The main disease elements are qi deficiency syndrome,marrow reduction syndrome,liver wind syndrome,phlegm turbidity syndrome and blood stasis syndrome.Phlegm turbidity syndrome and blood stasis syndrome may be the risk factors of SH in nOH patients.

关 键 词：神经源性直立性低血压 卧位高血压 中医证候要素 

分 类 号：R259[医药卫生—中西医结合]