老年高血压不同中医证型患者血压负荷特点分析

Study on Blood Pressure Load and TCM Syndrome Patterns in Elderly with Essential Hypertension

目的探讨老年高血压不同中医辨证分型患者血压负荷的差异。方法入选符合老年高血压1级、2级诊断标准的阴虚阳亢证、痰瘀阻络证及肾虚证的患者共133例,应用24h动态血压监测方法,观察24h血压变化水平,比较分析三个不同中医证型间的血压均值与血压负荷。结果肾虚证组白天平均收缩压均值明显高于阴虚阳亢证组(P<0.05),肾虚证组白天及夜间收缩压负荷较其他两组均显著增高(P<0.05),肾虚证组夜间舒张压负荷较阴虚阳亢证组显著增高(P<0.05)。结论肾虚证组血压负荷明显高于痰瘀阻络、阴虚阳亢组,预示着老年高血压肾虚证血压波动更加明显,临床应重视老年肾虚证高血压的稳定性及其靶器官损害的早期防治。

Objective To study the relation between blood pressure load and different traditional Chinese medicine（TCM） syndrome patterns in elderly with essential hypertension.Methods One hundred thirty-three elderly with hypertension were chosen and classified into yin deficiency with yang hyperactivity pattern,phlegm-stasis obstruction syndrome pattern,kidney deficiency pattern.The 24-hour ambulatory blood pressure monitorings were performed.The difference of mean blood pressure and blood pressure load were compared and analysed by TCM syndrome patterns.Results The daytime mean systolic blood pressure in patients with kidney deficiency pattern was significantly higher than that in yin deficiency with yang hyperactivity pattern（P0.05）.The daytime and nocturnal systolic blood pressure load in patients with kidney deficiency pattern was significantly higher than that in patients with two other patterns（P0.05）.The nocturnal diastolic blood pressure load in patients with kidney deficiency pattern was significantly higher than that in patients with yin deficiency with yang hyperactivity pattern（P0.05）.Conclusion Blood pressure load in patients with kidney deficiency pattern was significantly higher than that in patients with yin deficiency with yang hyperactivity pattern,phlegm-stasis obstruction syndrome pattern.It indicated that the fluctuation of blood pressure in elderly hypertension patients with kidney deficiency pattern was more serious.The result suggested that more attentions should be paid to the blood pressure stability in patients with kidney deficiency pattern for early prevention and treatment of the organs damage.