文献类型：期刊文献

中文题名：不同中医证型高血压病患者缺血性心血管病10年发病风险评估

英文题名：Risk Assessment of Ischemic Cardiovascular Disease in Patients with Hypertension of Different TCM Syndrome Types for 10 Years

作者：刘双芳[1];金华[1];靳利梅[1];刘志军[2];俞晓英[1];徐兴华[1];刘敏科[2];朱飞飞[1];张俊鹏[1]

第一作者：刘双芳

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：2020

卷号：27

期号：6

起止页码：28

中文期刊名：中国中医药信息杂志

外文期刊名：Chinese Journal of Information on Traditional Chinese Medicine

收录：CSTPCD;;CSCD:【CSCD_E2019_2020】；

基金：国家自然科学基金地区基金(81860832、81560716);甘肃省中医药管理局科研项目(GZK-2019-24);甘肃省高等学校科研项目协同创新团队项目(2017C-14)。

语种：中文

中文关键词：高血压病;中医证型;缺血性心血管病;风险评估

外文关键词：hypertension;TCM syndrome types;ischemic cardiovascular disease;risk assessment

摘要：目的分析不同中医证型高血压病患者缺血性心血管病(ICVD)10年发病风险,探讨二者相关性。方法收集2014年6月-2018年12月甘肃中医药大学附属医院317例高血压病患者一般资料、临床症状、既往史、个人史、生化检查资料,辨证分为肾气亏虚证、阴虚阳亢证、痰瘀互结证、肝火亢盛证,运用Framingham心血管危险评分表、国人ICVD 10年发病风险评估表2种心血管风险预测模型计算不同中医证型高血压病患者ICVD 10年危险度,总结证型与危险因素相关性。结果317例不同中医证型高血压病患者,经Framingham心血管危险评分表测得心血管病10年发病风险度差异有统计学意义(H=26.493,P=0.000),阴虚阳亢证、痰瘀互结证高于肝火亢盛证、肾气亏虚证(P<0.05);高血压病肝火亢盛证患者心血管病10年发病风险与吸烟、总胆固醇(TC)、收缩压呈正相关(P<0.05,P<0.01);肾气亏虚证患者心血管病10年发病风险与收缩压呈正相关(P<0.05),与TC呈负相关(P<0.05);阴虚阳亢证患者心血管病10年发病风险与吸烟、收缩压呈正相关(P<0.01),与高密度脂蛋白胆固醇(HDL-C)呈负相关(P<0.01);痰瘀互结证患者心血管病10年发病风险与年龄、吸烟、TC、收缩压呈正相关(P<0.01)。经国人ICVD 10年发病风险评估表测得不同证型高血压病患者ICVD 10年发病风险度差异有统计学意义(H=24.781,P=0.000),痰瘀互结证高于肝火亢盛证、肾气亏虚证、阴虚阳亢证(P<0.05);高血压病肝火亢盛证患者ICVD 10年发病风险与TC、收缩压、体质量指数(BMI)、吸烟呈正相关(P<0.01);肾气亏虚证患者ICVD 10年发病风险与年龄、收缩压、BMI、糖尿病呈正相关(P<0.01);阴虚阳亢证患者ICVD 10年发病风险与收缩压、糖尿病、吸烟呈正相关(P<0.01);痰瘀互结证患者ICVD 10年发病风险与年龄、TC、收缩压、BMI、糖尿病、吸烟呈正相关(P<0.05,P<0.01)。结论317例不同中医证型高血压病患者经Framingham心血管危险评分表测得心血管病10年发病风险度,阴虚阳亢证、痰瘀互结证高于肝火亢盛证、肾气亏虚证;经国人ICVD 10年发病风险评估表测得ICVD 10年发病风险度,痰瘀互结证高于肝火亢盛证、肾气亏虚证、阴虚阳亢证。
Objective To analyze the risk of ischemic cardiovascular disease(ICVD)in patients with hypertension of different TCM syndrome types for 10 years;To explore the correlation between them.Methods The information of 317 patients with essential hypertension from June 2014 to December 2018 in Affiliated Hospital of Gansu University of Chinese medicine was collected,including general data,clinical symptoms,past history,personal history,biochemical test results and so on.317 Cases were divided into four syndrome types:kidney qi deficiency syndrome,yin deficiency and yang hyperactivity syndrome,phlegm and blood stasis syndrome and liver fire hyperactivity syndrome.Framingham cardiovascular score scale and Chinese 10 years ischemic cardiovascular disease risk assessment form were used to predict cardiovascular risk.The risk of ICVD in patients with hypertension of different TCM syndrome types for 10 years was calculated,and the correlation between different TCM syndrome types and risk factors was summarized.Results Among the 317 patients with hypertension of different TCM syndrome types,Framingham cardiovascular score scale showed that there was statistical significance in the risk of cardiovascular disease(H=26.493,P=0.000).The risk in yin deficiency and yang hyperactivity syndrome group and phlegm and blood stasis syndrome group was higher than that in liver fire hyperactivity syndrome group and kidney qi deficiency syndrome group(P<0.05).The risk of 10-year cardiovascular disease in hypertensive patients with liver fire hyperactivity syndrome was positively correlated with smoking,total cholesterol(TC)and systolic blood pressure(P<0.05,P<0.01).The risk of cardiovascular disease in hypertensive patients with kidney qi deficiency syndrome for 10 years was positively correlated with systolic blood pressure(P<0.05)and negatively correlated with TC(P<0.05).The risk of 10-year cardiovascular disease in yin deficiency and yang hyperactivity syndrome was positively correlated with smoking and systolic blood pressure(P<0.01)and negatively correlated with high density lipoprotein(HDL-C)(P<0.01).In the group of phlegm and blood stasis syndrome,the risk of cardiovascular disease in 10 years was positively correlated with age,smoking,TC and systolic blood pressure(P<0.01).According to Chinese 10-year ICVD risk assessment form,the difference in the risk of 10-year ICVD of patients with hypertention of different TCM syndrome types was statistically significant(Η=24.781,P=0.000).The risk of 10-year ICVD in patients with phlegm and blood stasis syndrome was higher than that in liver fire hyperactivity syndrome group,kidney qi deficiency syndrome group and yin deficiency and yang hyperactivity syndrome group(P<0.05).The risk of 10-year ICVD in hypertensive patients with liver fire hyperactivity syndrome was positively correlated with TC,systolic blood pressure,body mass index(BMI)and smoking(P<0.01).The 10-year risk of ICVD in kidney qi deficiency syndrome was positively correlated with age,systolic blood pressure,BMI and diabetes(P<0.01).The risk of 10-year ICVD in yin deficiency and yang hyperactivity syndrome was positively correlated with systolic blood pressure,diabetes and smoking(P<0.01).The risk of 10-year ICVD in phlegm and blood stasis syndrome was positively correlated with age,TC,systolic blood pressur,BMI,diabetes and smoking(P<0.05,P<0.01).Conclusion The risk of cardiovascular disease in 10 years is measured by Framingham cardiovascular score scale in 317 patients with hypertension of different TCM syndrome types.The risk of cardiovascular disease in yin deficiency and yang hyperactivity syndrome and phlegm and blood stasis syndrome is higher than that in liver fire hyperactivity syndrome and kidney qi deficiency syndrome.According to the risk assessment scale of ICVD in Chinese for 10 years,the risk of ICVD in phlegm and blood stasis syndrome group is higher than that in liver fire hyperactivity syndrome,kidney qi deficiency syndrome and yin deficiency and yang hyperactivity syndrome.