老年高血压病患者中医证素分布及与危险因素相关性研究  

Study on Distribution of Traditional Chinese Medicine Syndrome Elements and Correlation with Risk Factors in Elderly Patients with Hypertension

作　　者：赵鸣一 陈晓喆 符德玉[1] ZHAO Mingyi;CHEN Xiaozhe;FU Deyu(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437

出　　处：《辽宁中医杂志》2024年第2期24-28,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82174130,81774111);上海中医药大学预算内项目(自然科学类)(2021LK097);上海中医药大学产业发展中心医养结合科创项目(YYKC-2021-01-157);上海市科学技术委员会科研计划项目(19401970400);上海市医院中药制剂产业转化协同创新中心项目。

摘　　要：目的探索老年高血压病患者各中医证素分布情况及其与危险因素的相关性。方法采用回归分析、卡方检验,对上海地区480例老年高血压病患者进行信息采集并分析中医证素分布特点及各证素与危险因素的相关性。结果(1)证素频率方面:气虚证(50.83%)>阳亢证(43.75%)>痰浊证(40.42%)>血瘀证(38.13%)>血虚证(36.25%)>阴虚证(22.71%)>气滞证(10.00%)>阳虚证(6.04%);证型分布方面:虚实夹杂证(62.29%)>实证(19.17%)>虚证(18.54%);应证组合方面:双证素(35.42%)>三证素(26.67%)>单证素(20.63%)>四证素(10.42%)。(2)回归分析提示:对于不同中医证素而言,痰证患者容易合并总胆固醇(total cholesterol,TC)、身体体质量指数(body mass index,BMI)升高及糖尿病病史;血瘀证患者多合并冠心病、脑血管疾病史,且与甘油三酯(triglyceride,TG)升高密切相关;阳亢证与TC、TG升高;室间隔增厚密切相关;气滞证患者与吸烟饮酒史、BMI升高相关;阳虚证患者多高血压病程较长且合并TG升高及房颤病史;血虚证患者常伴随高龄、久病等;气虚患者与高龄、久病、射血分数降低、房颤密切相关;阴虚患者与糖尿病、高龄、吸烟史、饮酒史、左室射血分数降低密切相关;(3)对虚证组、实证组及虚实夹杂证组患者进行回归分析结果显示:高龄、久病、左室射血分数下降及有糖尿病病史患者易表现为虚证,TG水平、TC水平、室间隔厚度升高患者易表现为实证;而BMI升高、房颤家族史、TG水平、饮酒/吸烟史的患者多表现为虚实夹杂证。结论随着高龄、久病及血压的升高,老年高血压病患者中医证素大致呈现由实转虚的变化;阳亢、痰浊、血瘀为老年高血压病患者常见实证证素,气虚、阴虚为常见虚证证素,证型以虚实夹杂多见;证型分布与危险因素密切相关,实证与超重/肥胖、血脂异常、吸烟/饮酒史相关,虚证证素多与年龄、病程、合并糖尿病、房�Objective To explore the distribution of each TCM syndrome elements and its correlation with risk factors in elderly patients with hypertension.Methods Regression analysis and chi-square test were used to collect information and analyze the distribution characteristics of TCM syndrome elements and the correlation between each syndrome element and risk factors in 480 elderly patients with hypertension in Shanghai.Results(1)Frequency of syndrome elements:Qi deficiency syndrome(50.83%)>Yang hyperactivity syndrome(43.75%)>phlegm turbid syndrome(40.42%)>blood stasis syndrome(38.13%)>blood deficiency syndrome(36.25%)>Yin deficiency syndrome(22.71%)>Qi stagnation syndrome(10.00%)>Yang deficiency syndrome(6.04%);distribution of syndromes:mixed deficiency and excess syndrome(62.29%)>excess syndrome(19.17%)>deficiency syndrome(18.54%);the combination of elements:double elements(35.42%)>triple elements(26.67%)>single elements(20.63%)>quadruple elements(10.42%).(2)The regression analysis suggested that for the different TCM syndrome elements,the patients with phlegm syndrome were more likely to have a combination of total cholesterol(TC),elevated body mass index(BMI)and a history of diabetes.The patients with blood stasis syndrome were more likely to have a combination of coronary heart disease and cerebrovascular disease and were closely associated with elevated triglyceride(TG).The patients with Yang excess syndrome were closely associated with TC,elevated TG and septal thickening.The patients with Qi stagnation were associated with a history of smoking and alcohol consumption and elevated BMI.The patients with Yang deficiency syndrome had a longer duration of hypertension and a combination of elevated TG.The patients with blood deficiency were often associated with advanced age,prolonged illness and thin pulse.The patients with Qi deficiency were closely associated with advanced age,prolonged illness,reduced ejection fraction and atrial fibrillation.The patients with Yin deficiency were closely associated with diabetes,ad

关 键 词：老年高血压病 心血管疾病危险因素 中医证素 心血管疾病 

分 类 号：R259.441[医药卫生—中西医结合]