文献类型：期刊文献

中文题名：阻塞性睡眠呼吸暂停低通气综合征相关性高血压与中医痰湿体质的中西医研究进展

英文题名：Research progress of TCM and Western medicine of obstructive sleep apnea hypopnea syndrome-related hypertension and TCM phlegm-dampness constitution

作者：杨文媛[1];于小刚[1];郭雪松[1];黄进学[1];解欢欢[2];卢玉俊[2];李应东[1]

第一作者：杨文媛

机构：[1]甘肃中医药大学,甘肃兰州730000;[2]甘肃中医药大学附属医院,甘肃兰州730000

第一机构：甘肃中医药大学

年份：2022

卷号：14

期号：16

起止页码：120

中文期刊名：中医临床研究

外文期刊名：Clinical Journal Of Chinese Medicine

基金：国家重点研发计划资助项目:慢性失眠中医诊疗新方案及机制研究(2018YFC1705600),子课题:失眠及其与更年期综合征、高血压、老年轻度认知障碍等相关病症的关系及综合治理方案研究(2018YFC1705604);国家中医药管理局重大疑难疾病中西医临床协作试点项目“难治性高血压”(国中医药办医政发[2018]3号)。

语种：中文

中文关键词：阻塞性睡眠呼吸暂停低通气综合征;高血压病;痰湿体质;中西医研究进展

外文关键词：Obstructive sleep apnea hypopnea syndrome;Hypertension;Phlegm and dampness constitution;Research progress of TCM and Western medicine

摘要：睡眠呼吸障碍是一种全球慢性疾病,是很多心血管事件发生的独立危险因素,以阻塞性睡眠呼吸暂停低通气综合征最为多见。阻塞性睡眠呼吸暂停低通气综合征的发病率高,以间歇性低氧血症、高碳酸血症及反复睡眠觉醒为特征,其发病率随着年龄的增加而呈上升趋势。阻塞性睡眠呼吸暂停低通气综合征与高血压间存在密切关联,现代研究观察到将近50%的高血压病患者合并有阻塞性睡眠呼吸暂停低通气综合征,它们常同时存在并相互为病。长期阻塞性睡眠呼吸暂停低通气综合征所致的高血压病患者,血压变化有独特的特征,以夜间及晨起血压升高尤甚,表现为“杓形”甚至“反杓形”。目前临床通常采用持续正压通气以及纠正睡眠体位法治疗阻塞性睡眠呼吸暂停低通气综合征,但持续正压通气减少心血管事件风险的疗效仍不明确,故对病因病机的探讨对此病的诊疗有重要意义。其西医发病机制的核心在于间断性低氧血症导致的人体神经及内分泌紊乱。由于反复呼吸暂停引起的交感神经过度激活、全身炎症反应及氧化应激反应等,均可使机体血压升高;中医则强调“肥人多痰”,将阻塞性睡眠呼吸暂停低通气综合征及高血压病分别归于“鼾眠”“眩晕”范畴,认为痰湿质是二者发生的重要病理基础。文章将探究阻塞性睡眠呼吸暂停低通气综合征相关性高血压的发病机制以及其与中医痰湿体质的关系,以便更好地指导中西医临床用药。
Sleep-disordered breathing is a global chronic disease and an independent risk factor for many cardiovascular events, among which obstructive sleep apnea hypopnea syndrome(OSAHS) is the most common. The incidence of OSAHS is very high, characterized by intermittent hypoxemia, hypercapnia, and repeated sleep awakenings, and its incidence tends to increase with age. There is a close relationship between OSAHS and hypertension. Modern studies have observed that nearly 50% of hypertensive patients have obstructive sleep apnea hypopnea syndrome, and they often coexist and mutually affect each other. The blood pressure changes of hypertensive patients caused by long-term OSAHS have unique characteristics, especially when the blood pressure rises at night and in the morning, which is “dipper-shaped” or even “reverse dipper-shaped”. At present, continuous positive airway pressure and sleep position correction are usually used in clinical treatment of OSAHS. However, the efficacy of CAPA in reducing the risk of cardiovascular event is still unclear, so the investigation of the etiology and pathogenesis of this disease is of great significance. The core of the pathogenesis of Western medicine lies in the human neurological and endocrine disorders caused by intermittent hypoxemia. Excessive activation of sympathetic nerves, systemic inflammation, and oxidative stress caused by repeated apneas can all increase blood pressure. TCM emphasizes “fat people have more phlegm” and puts OSAHS and hypertension in the categories of “snoring sleep” and “dizziness” respectively, and believes that phlegm-dampness is an important pathological basis for the occurrence of both. This article will explore the pathogenesis of OSAHS-related hypertension and its relationship with the phlegm-dampness constitution of TCM, so as to better guide the clinical medication of TCM and Western medicine.