文献类型：期刊文献

中文题名：不同中医证型高血压患者血压变异性及影响因素分析

英文题名：Analysis on Blood Pressure Variability and Its Influencing Factors of Hypertensive Patients with Different TCM Syndromes

作者：刘志军[1];金华[2,3];韩艳萍[1];卢玉俊[1];苏莉莉[2];郑龙飞[2];刘双芳[2];曹强[2]

第一作者：刘志军

机构：[1]甘肃中医药大学附属医院,甘肃兰州730000;[2]甘肃中医药大学,甘肃兰州730000;[3]甘肃省中医方药挖掘与创新转化重点实验室,甘肃兰州730000

第一机构：甘肃中医药大学第二附属医院

年份：2018

卷号：25

期号：4

起止页码：35

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_E2017_2018】；

基金：甘肃省中医药管理局科研项目(GZK-2013-41);甘肃省高等学校科学研究创新团队项目(2017C-14)

语种：中文

中文关键词：高血压;中医证型;血压变异性;影响因素

外文关键词：hypertension; TCM syndromes; blood pressure variability; influencing factors

摘要：目的调查高血压患者中医证型的分布情况,分析其血压变异性(BPV)参数特征及其影响因素的相关性。方法纳入高血压患者515例,进行辨证分型,记录患者的人口学资料、实验室指标、危险因素及临床症状,并分析其相关性。采用24 h动态血压记录BPV参数,比较不同中医证型高血压患者BPV参数差异,包括24 h平均收缩压(24 h MSBP)、24 h平均舒张压(24 h MDBP)、24 h平均收缩压变异系数(24 h MSCV)、24 h平均舒张压变异系数(24 h MDCV)、日间(6:00-22:00)平均收缩压(DMSBP)、日间平均舒张压(DMDBP)、日间平均收缩压变异系数(DMSCV)、日间平均舒张压变异系数(DMDCV)、夜间(22:00-次日6:00)平均收缩压(NMSBP)、夜间平均舒张压(NMDBP)、夜间平均收缩压变异系数(NMSCV)、夜间平均舒张压变异系数(NMDCV)、夜间血压下降率。结果阴虚阳亢证、痰瘀互结证、肝火亢盛证、肾气亏虚证、痰湿壅盛证分别为160、136、83、69、67例。不同证型间年龄、性别差异有统计学意义(P<0.05);与阴虚阳亢证比较,痰瘀互结证、肝火亢盛证、肾气亏虚证、痰湿壅盛证24 h MSBP、24 h MDBP、DMSBP、DMDBP、NMSBP、NMDBP及24 h MSCV、24 h MDCV、DMSCV、DMDCV、NMSCV、NMDCV差异有统计学意义(P<0.05)。性别(女性)、睡眠时间<6 h、摄入钠盐量、情绪激动、文化程度与阴虚阳亢证呈正相关;性别(女性)、年龄、摄入钠盐量、文化程度与痰瘀互结证呈正相关;年龄、摄入钠盐量、高血压家族史、文化程度与痰湿壅盛证呈正相关。结论高血压阴虚阳亢证患者血压及BPV参数最高,高血压痰湿壅盛证患者血压及BPV参数最低;阴虚阳亢证、痰瘀互结证、痰湿壅盛证与引发高血压患者心脑血管事件的影响因素关系较为密切。
Objective To investigate the TCM syndrome type distribution of hypertensive patients;To analyze the correlation of blood pressure variability(BPV)parameters and its influence factors.Methods The data of515hypertensive patients including demographic information,laboratory test parameters,risk factors and clinical symptoms were collected for correlation analysis and the patients were divided to different TCM syndromes.BPV parameters of515hypertensive patients were acquired by24h ambulatory blood pressure,then our study analyzed and compared the differents of24h MSBP,24h MDBP,24h MSCV,24h MDCV,DMSBP,DMDBP,DMSCV,DMDCV,NMSBP,NMDBP,NMSCV,NMDCV between different TCM syndromes.Results There were160cases with hyperactivity of yang due to yin deficiency syndrome,136cases with turbid phlegm and blood stasis syndrome,83cases with overabundant liver-fire syndrome,69cases with deficiency of kidney qi,and67cases with abundant phlegm-dampness syndrome.The difference of gender and age was statistically significant between different TCM syndromes(P<0.05).Compared with the group of hyperactivity of yang due to yin deficiency syndrome,the level of24h MSBP,24h MDBP,DMSBP,DMDBP,NMSBP,NMDBP,24h MSCV,24h MDCV,DMSCV,DMDCV,NMSCV and NMDCV had statistical significance in the groups of turbid phlegm and blood stasis syndrome,overabundant liver-fire syndrome,deficiency of kidney qi and abundant phlegm-dampness syndrome(P<0.05).Logistic regression analysis showed that the factors including gender(female),insomnia(time<6h),sodium salt intake,emotion and educational level were positively correlated to hyperactivity of yang due to yin deficiency,and other factors including gender(female),age,sodium salt intake and educational level positively correlated with turbid phlegm and blood stasis syndrome.And the study also showed that age,sodium salt intake,family history of hypertension and educational level were positively correlated to abundant phlegm-dampness syndrome.Conclusion The BPV parameters and blood pressure are significantly increased d in the group of hyperactivity of yang due to yin deficiency than other groups,but decrease in the group of abundant phlegm-dampness syndrome.Hyperactivity of yang due to yin deficiency syndrome,abundant phlegm-dampness syndrome and turbid phlegm and blood stasis syndrome are closely related to the influencing factors that lead to cardiovascular and cerebrovascular events.