高血压患者中医证候与合并病的相关性研究  

Research on the correlation between TCM syndromes and comorbidities in patients with hypertension

作　　者：代爽 严祖桢 丁宇坤 王显[1] DAI Shuang;YAN Zuzhen;DING Yukun;WANG Xian(Department of Cardiology,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Wangsiying Community Health Service Center,Beijing 100124)

机构地区：[1]北京中医药大学东直门医院心内科,北京100700 [2]北京朝阳区王四营社区卫生服务中心,北京100124

出　　处：《北京中医药》2025年第3期307-310,共4页Beijing Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局心脉病症益气活血重点研究室项目(2024-JYB-KYPT-10)。

摘　　要：目的 探究高血压患者中医证候特点与其合并病的相关性。方法 选择2021年1—12月北京朝阳区王四营社区卫生服务中心确诊为高血压的患者1 437例,通过检索相关文献、流行病学报告及咨询专家确定高血压的主要证候为肝火亢盛证、阴虚阳亢证、痰湿内盛证、肝肾阴虚证、脾肾亏虚证、气血不足证、气滞血瘀证、肾阳虚衰证,用SAS9.4统计软件进行高血压患者中医证候与合并病的对应分析。结果 1 437例确诊高血压患者中排名前三的证候为痰湿内盛证243例,脾肾亏虚证201例,肾阳虚衰证179例。高血压合并冠心病与气滞血瘀证的关系最为紧密,相关距离为0.040 74;合并血脂异常与肝火亢盛证的关系最为紧密,相关距离为0.054 61;合并2型糖尿病与肝火亢盛证的关系最为紧密,相关距离为0.046 07;合并脑血管疾病与气滞血瘀证关系最为紧密,相关距离为0.114 62;合并高尿酸血症与阴虚阳亢证关系最为紧密,相关距离为0.259 70。结论 合并不同疾病对高血压证候产生一定影响,临床应掌握患者整体情况,科学、精准辨证。Objective To explore the correlation between the characteristics of traditional Chinese medicine(TCM)syndromes and comorbidities in patients with hypertension.Methods A total of 1437 patients diagnosed with hypertension at Wangsiying Community Health Service Center in Chaoyang District,Beijing,from January to December 2021 were selected.The primary TCM syndromes associated with hypertension,including liver fire hyperactivity syndrome,yin deficiency and yang hyperactivity syndrome,phlegmdampness accumulation syndrome,liver and kidney yin deficiency syndrome,spleen and kidney deficiency syndrome,qi and blood deficiency syndrome,qi stagnation and blood stasis syndrome,and kidney yang deficiency syndrome,were determined by reviewing relevant literature,epidemiological reports,and consulting experts.Correspondence analysis between TCM syndromes and comorbidities in patients with hypertension was performed using SAS 9.4 statistical software.Results Among the 1437 confirmed cases of hypertension,the top three syndromes were phlegm-dampness accumulation syndrome(243 cases),spleen and kidney deficiency syndrome(201 cases),and kidney yang deficiency syndrome(179 cases).Hypertension combined with coronary heart disease was most closely related to qi stagnation and blood stasis syndrome,with a correlation distance of 0.04074.Hypertension combined with dyslipidemia was most closely related to liver fire hyperactivity syndrome,with a correlation distance of 0.05461.Hypertension combined with type 2 diabetes mellitus was most closely related to liver fire hyperactivity syndrome,with a correlation distance of 0.04607.Hypertension combined with cerebrovascular disease was most closely related to qi stagnation and blood stasis syndrome,with a correlation distance of 0.11462.Hypertension combined with hyperuricemia was most closely related to yin deficiency and yang hyperactivity syndrome,with a correlation distance of 0.25970.Conclusion Different comorbidities have specific impacts on the syndromes of hypertension.Clinicians shoul

关 键 词：高血压 对应分析 合并病 冠心病 糖尿病 脑血管疾病 高尿酸血症 中医证候 

分 类 号：R259[医药卫生—中西医结合]