基于某医院医院信息系统高血压病住院患者探讨高血压病中医证型的分布规律

Exploration on the distribution of TCM syndromes of hypertension based on the clinical data of hypertension inpatients in HIS system of a hospital

目的:探讨高血压病中医证型的分布规律,为中医临床防治高血压病提供参考依据。方法:选取2017年1月—2021年12月甘肃中医药大学附属医院医院信息系统中高血压病住院患者1261例,对收集的病例资料进行回顾性研究,采用卡方检验分析中医证型在性别、年龄、病程、高血压病分级以及高血压病合并症上的分布规律。结果:高血压病中医证型的分布为痰瘀互结610例(610/1261,48.4%)、肝肾阴虚167例(167/1261,13.2%)、气虚血瘀124例(124/1261,9.8%)、肝阳上亢123例(123/1261,9.8%)、肾气亏虚106例(106/1261,8.4%)、痰湿中阻74例(74/1261,5.9%)、阴虚阳亢57例(57/1261,4.5%)。高血压病中医证型在性别分布上的差异具有统计学意义(P<0.05),男性高血压病患者以痰瘀互结、肝阳上亢为主,女性高血压病患者以痰瘀互结、肝肾阴虚为主;高血压病中医证型在年龄分布上的差异具有统计学意义(P<0.05),70岁以下的高血压病患者以痰瘀互结、肝阳上亢为主,70岁以上的高血压病患者以痰瘀互结、肝肾阴虚为主。高血压病中医证型在高血压病合并症分布上的差异具有统计学意义(P<0.05),且高血压病合并糖尿病、脑卒中、冠状动脉粥样硬化性心脏病(简称冠心病)、心功能不全与高血压肾病的差异有统计学意义(P<0.005)。高血压病中医证型在病程和高血压病分级分布上的差异无统计学意义(P>0.05)。结论:高血压病中医证型的分布以痰瘀互结和肝肾阴虚为主,高血压病中医证型在性别、年龄和高血压病合并症上存在不同的分布规律,中医临床上可以参考本研究结果,精准防治高血压病。

Objective:To explore the distribution of TCM syndrome types of hypertension,and to provide a reference for the clinical prevention and treatment of hypertension.Methods:A total of 1261 hospitalized hypertensive patients in HIS system of the Affiliated Hospital of Gansu University of Traditional Chinese Medicine from January 2017 to December 2021 were selected.The collected case data were retrospectively studied.Chi-square test was used to analyze the distribution of TCM syndrome types in terms of gender,age,disease course,hypertension grade and hypertension complications.Results:The distribution of TCM syndrome types of hypertension included 610 cases(610/1261,48.4%)of interjunction of phlegm and stasis,167 cases(167/1261,13.2%)of Yin(阴)deficiency of liver and kidney,124 cases(124/1261,9.8%)of Qi(气)deficiency and blood stasis,123 cases(123/1261,9.8%)of hyperactivity of liver Yang(阳),106 cases(106/1261,8.4%)of deficiency of kidney Qi,74 cases(74/1261,5.9%)of obstruction of phlegm and dampness,57 cases(57/1261,4.5%)of Yin deficiency and Yang hyperactivity.There were statistically significant differences in the distribution of TCM syndrome types of hypertension in gender(P<0.05).Male patients with hypertension were mainly characterized by mutual junction of phlegm and blood stasis and hyperactivity of liver Yang,while female patients were mainly characterized by mutual junction of phlegm and blood stasis and Yin deficiency of liver and kidney.There were significant differences in the distribution of TCM syndrome types of hypertension in age(P<0.05).Hypertension patients under 70 years old were mainly characterized by interjunction of phlegm and blood stasis and hyperactivity of liver Yang,while hypertension patients over 70 years old were mainly characterized by interjunction of phlegm and blood stasis and Yin deficiency of liver and kidney.There were significant differences in the distribution of TCM syndrome types of hypertension in hypertension complications(P<0.05),and there were significant differences in hypertension complicated with diabetes mellitus,stroke,coronary heart disease,cardiac insufficiency and hypertensive nephropathy(P<0.005).There was no significant difference in the distribution of TCM syndrome types of hypertension in the course of disease and the grade of hypertension(P>0.05).Conclusion:The distribution of TCM syndrome types of hypertension is mainly phlegm and blood stasis interjunction and liver and kidney Yin deficiency.There are different distribution rules of TCM syndrome types of hypertension in gender,age and hypertension complications.The results of this study can be referred to in the clinical practice to accurately prevent hypertension.