老年高血压病虚证患者动态血压监测的时辰血压水平研究

The Relationship between Deficiency Syndrome and Blood Pressure at Different Time in Elderly with Essential Hypertension

目的探讨老年高血压病(EH)阴虚证、阳虚证、阴阳两虚证患者基于动态血压监测的子时、卯时、午时、酉时4个时辰血压水平规律,以指导临床补益药的服用方法。方法对99例老年EH患者行动态血压测定和中医辨证。99例EH患者按中医辨证分为3组,即阴虚组、阳虚组、阴阳两虚组,观察各组基于动态血压监测的子时、卯时、午时、酉时的血压水平。结果阴虚组、阳虚组、阴阳两虚组的收缩压(SBP)、舒张压(DBP)水平在子时处于最低水平,在酉时处于最高水平(阴阳两虚组SBP在卯时最高);阴虚组、阳虚组、阴阳两虚组在酉时的SBP与子时比较有统计学意义(P<0.05),DBP与酉时比较差异有统计学意义(P<0.05或P<0.01)。3组间各时辰的HR比较无统计学意义。结论高血压病虚证的中药治疗应以补益心肾为主。服药时间,补阴应在午时服药,以滋补心阴为主;补阳应在酉时服药,以补益肾阳为主;当补肾时,无论补肾阳还是益肾阴,应选择在酉时服药。

Objective To explore the relationship between deficiency syndrome （deficiency syndrome of Yin,deficiency syndrome of Yang, deficiency syndrome of Yin and Yang） and blood pressure at different time in elderly with essential hypertension （EH） based an blood pressure monitoring system. Methods The ambulatory blood pressure was determined in 99 elderly patients （pts） of EH and deficiency syndrome （deficiency syndrome of Yin,defieiency syndrome of Yang,deficiency syndrome of Yin and Yang） by blood pressure monitoring system at different time （Zi Period,Mao Period,Wu period,You period）. Results Thesystolic blood pressure （SBP） and diastolic blood pressure （DBP） in pts with deficiency syndrome of Yin,deficieney syndrome of Yang,deficieney syndrome of Yin and Yang were the lowest level at Zi period （Midnight） and the highest level at You period. The SBP at You period was higher than that at Zi period （P〈0.05）. The DBP at You period was obviously higher than that at Zi period （P〈0.01）. The SBP and DBP at You period was higher than that at Wu period （P〈0.05）. Conclusion The elderly pts with EH and deficiency syndrome should be treated with Chinese drugs for invigoration on heart and kidney. The invigoration medicine of Yin （mainly nourishing Yin of heart） should he taken at Wu period. The Chinese drugs for invigoration on Yang （mainly nourishing Yang of kidney） should be taken at You period. The Chinese drugs for invigoration on kidney （both Yin and Yang of kidney） should be taken at You period.