中医体质类型与高血压的相关性研究

Relationships between constitutional types of traditional Chinese medicine and hypertension

目的:研究中医体质类型与原发性高血压的相关性,为体质与疾病相关理论提供流行病学调查依据。方法:汇集我国9省市(江苏、安徽、甘肃、青海、福建、北京、吉林、江西、河南)横断面中医体质调查数据7782例。中医体质调查采用标准化的中医体质量表实施,体质类型(平和质、气虚质、阳虚质、阴虚质、痰湿质、湿热质、血瘀质、气郁质、特禀质)的判定应用判别分析法。采用多元逐步logistic回归分析筛选原发性高血压有意义的主要体质影响因素。结果:控制性别、年龄、婚姻状况、职业、文化程度因素后,多元逐步logistic回归分析模型入选了3个中医体质因素,按影响程度的大小依次为痰湿质、阴虚质和气虚质,其比值比(oddsratio,OR)和95%可信区间(confidenceinterval,CI)分别为2.00[1.58,2.55]、1.66[1.33,2.08]和1.37[1.13,1.66]。以性别分层分析,男性高血压的主要体质影响因素是痰湿质、阴虚质,其OR值和95%CI分别为1.61[1.22,2.14]、1.60[1.17,2.19];女性高血压的主要体质影响因素是痰湿质、阴虚质和气虚质,其OR值和95%CI分别为2.80[1.79,4.39]、1.55[1.13,2.14]和1.39[1.05,1.84],痰湿质对女性高血压的影响更显著。结论:痰湿质、阴虚质和气虚质是原发性高血压的主要体质影响因素,男性和女性高血压的中医体质影响因素不同。

Objective： To investigate the relationships between constitutional types of traditional Chinese medicine （TCM） and hypertension so as to provide epidemiological evidence for the theory of correlation between constitutionand disease.Methods： A cross-sectional survey of TCM constitution data from a population of 7 782 from Beijng and 8 provinces of China （Jiangsu, Anhui, Gansu, Qinghai, Fujian, Jilin, Jiangxi, and Henan） was made in the study. The survey of TCM constitutions was performed by standardized TCM Constitution Questionnaire. Discriminatory analysis was used to judge the individual constitutional types including normal constitution, and qi deficiency, yang deficiency, yin deficiency, phlegm-dampness, damp-heat, blood stasis, qi stagnation and special constitutions. A multiple stepwise logistic regression analysis was applied to explore the significantly influential constitutional factors of hypertension.Results： After controlling several factors like gender, age, marital status, occupation, and educational background, three TCM constitutional factors according to different degrees of relative risks were entered into the multiple stepwise logistic regression model. The three factors were phlegm-dampness, yin deficiency and qi deficiency constitutions, and the odds ratio （OR） and 95% confidence interval （CI） were 2.00 [1.58, 2.55], 1.66 [1.33, 2.08] and 1.37 [1.13, 1.66] respectively. The main constitutional influential factors of hypertension in male patients were phlegm-dampness and yin deficiency constitutions, with OR and 95% CI of 1.61 [1. 22, 2.14] and 1.60 [1. 17, 2.19]. Phlegm-dampness, yin deficiency and qi deficiency constitutions were the main constitutional influential factors of hypertension in female patients. The OR and 95 % CI were 2.80 [1.79, 4.39], 1.55 [1.13, 2.14] and 1.39 [1.05, 1.84] respectively. Phlegm-dampness constitution had more influence on hypertension in female patients than other constitution types.Conclusion： Phlegm-dampness, yin deficiency, and qi deficiency constitutions are the main influential factors of hypertension. Hypertensive patients with different gender have different constitutional influential factors.