心血管疾病高危人群中医健康管理干预效果分析  

Analysis on effect of traditional Chinese medicine health management intervention for people at high risk of cardiovascular disease

作　　者：赵欣 李瑞杰 王彦辉 罗西川 赵斌 ZHAO Xin;LI Rui-jie;WANG Yan-hui(Beijing First Middle and Western Medicine Combined Hospital,Beijing 100026,China)

机构地区：[1]北京市第一中西医结合医院,100026

出　　处：《中国实用医药》2023年第13期137-141,共5页China Practical Medicine

基　　金：2015年度北京市朝阳区科技计划课题(项目编号:CYSF1518);北京市优秀人才培养资助青年骨干个人项目(项目编号:北京市委组织部:2015000052580G261)。

摘　　要：目的 对心血管疾病高危人群进行中医证型分析,按证型进行中医干预,判断干预效果,为中医辨证防治心血管疾病提供科学依据。方法 选择体检中心体检人群为筛查对象,应用《国人缺血性心血管病(ICVD)10年发病风险评估表》筛选出符合入组标准的体检者200例进入干预组(制定个性化干预方案),200例进入对照组(常态管理)。比较两组一般情况,分析心血管疾病高危人群的中医证型分布情况,比较两组危险度分级及管理率,管理前后危险度分级情况,管理前后危险因素情况,管理前和随访1年后体格检查和生化检查指标[体质量指数(BMI)、收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]。结果 两组性别比例、年龄、吸烟比例比较,差异无统计学意义(P>0.05)。高血压和高血糖人群以痰浊内阻证居首;血脂异常人群以心肾阴虚证居首;超重或肥胖、吸烟人群以心脉瘀阻证居首。此三类证型是心血管疾病高风险人群存在的主要证型。两组管理率比较,差异无统计学意义(P>0.05)。管理后,干预组的危险度分级优于对照组,差异具有统计学意义(Z=1.994,P=0.046<0.05)。管理后,干预组高血压、血脂异常、高血糖、超重或肥胖、吸烟比例分别为12.5%、13.0%、10.5%、7.5%、3.0%,均低于对照组的20.5%、21.5%、17.5%、14.0%、8.0%,差异具有统计学意义(P<0.05)。干预组随访1年后的BMI、SBP、DBP、FPG、TG、TC低于本组管理前,HDL-C高于本组管理前,差异具有统计学意义(P<0.05)。对照组随访1年后的BMI、DBP、FPG、TC、TG低于本组管理前,差异具有统计学意义(P<0.05)。随访1年后,干预组的SBP、DBP低于对照组,HDL-C高于对照组,差异具有统计学意义(P<0.05)。结论 中医脏腑辩证处方干预可以改善心血管疾病危险因素,降低心血管疾病发病风险。Objective To analyze the traditional Chinese medicine syndrome of people at high risk of cardiovascular diseases,to carry out traditional Chinese medicine interventions according to the syndromes,judge the intervention effects,so as to provide a scientific basis for traditional Chinese medicine syndrome differentiation and prevention of cardiovascular diseases.Methods The physical examination population in physical examination center was selected as the screening targets,and 200 cases meeting the inclusion criteria were selected into the intervention group(to develop personalized intervention regimen)and 200 cases into the control group(normal management)by applying the"10-year risk estimation of ischemic cardiovascular disease(ICVD)in Chinese".The general conditions of the two groups were analyzed to analyze the distribution of traditional Chinese medicine syndrome differentiation in the high-risk group of cardiovascular diseases;comparison was made on the risk classification and management rate,risk classification before and after management,risk factors before and after management,physical examination and biochemical examination indexes[body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting plasma glucose(FPG),triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)]before management and after 1 year of follow-up.Results There was no statistically significant difference between the two groups in terms of gender ratio,age,and smoking ratio(P>0.05).For hypertension and hyperglycemia,the phlegm stasis syndrome was the most common;for dyslipidemia,the syndrome of yin deficiency of heart and kidney was the most common;for overweight or obese people and smokers,the syndrome of blood stasis in the heart vessels was the most common.These three syndromes are the main syndromes in the high-risk population of cardiovascular disease.There was no statistically significant difference in management rate between the two grou

关 键 词：心血管疾病 中医证型 健康管理 

分 类 号：R259[医药卫生—中西医结合]