高血压病中医证素分布规律及证候特征研究

Distribution of TCM Syndromes and Syndromes Characteristics of Hypertension

目的探讨高血压病患者的中医证素分布规律及其证候特征。方法现场采集湖南中医药大学第一附属医院2019年3月—2019年8月心血管内科住院病人的一般资料、症状、体征及四诊资料,用证素积分的方式对纳入患者进行证素辨证,并分析其临床特点。结果315例高血压病患者共得到常见证素16种,病位证素由高到低依次为肾、心、肝、肺和脾,病性证素由高到低依次为气虚、痰、阴虚、血虚、阳虚、精亏、湿、血瘀、阳亢、水停和气滞,常见临床证型为阴虚阳亢证、气滞血瘀证、痰湿内停证、气血不足证、脾肾亏虚证。结论肝阳上亢、阴阳两虚、气滞水停、痰饮瘀血为高血压病的常见证候特点。随着大数据技术在中医定量化诊断应用中不断深入,证素定量化辨证诊断及模型将成为诊断模型研究的重要工具和方法,同时亦可以在临床精准诊治中执简驭繁。

Objective To explore the distribution of tradition Chinese medicine syndrome elements in patients with hypertension and the syndrome characteristics thereof.Methods General data,symptoms,signs and four diagnosis data of inpatients in cardiovascular medicine of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from March 2019 to August 2019 were collected on site,syndrome element differentiation was implemented on the included patients via the method of syndrome element integral,and in addition,the clinic characteristics were analyzed accordingly.Results A total of 16 common syndrome elements were found in 315 patients with hypertension.From high to low,the syndrome elements of disease location were kidney,heart,liver,lung and spleen;and from high to low,the syndrome elements of disease natures were Qi deficiency,phlegm,Yin deficiency,blood deficiency,Yang deficiency,essence deficiency,dampness,blood stasis,Yang hyperactivity,water stagnation and Qi stagnation.The common clinical syndrome types were Yin deficiency and Yang hyperactivity,Qi stagnation and blood stasis,phlegm dampness stagnation,deficiency of Qi and blood,deficiency of spleen and kidney.Conclusion The syndrome characteristics of hyperactivity of liver Yang,deficiency of Yin and Yang,stagnation of Qi and stagnation of water,phlegm and blood stasis are common in hypertension.With the big data technology continuously deepening into the quantitative diagnosis of tradition Chinese medicine,the quantitative differentiation diagnosis of syndrome elements and its model will become a significant tool and method of diagnosis model research.Meanwhile,it can also be used in clinical accurate diagnosis and treatment to control complexity with simple methods.