老年高血压中医证型与血压变异性临床探讨

Clinical Discussion of Elderly Primary Hypertension and Blood Pressure Variability

目的探讨老年原发性高血压中医证型与血压变异性之间的相关性,为老年原发性高血压中医辨证分型提供客观化标准。方法采用24 h动态血压检测技术,对103例入选老年高血压患者监测血压,同时对其进行中医辨证分型,观察各证型的动态血压数据。结果 (1)老年高血压患者中肾精不足证型在所有证型中所占比例最高,与其他证型组比较差异有统计学意义;(2)瘀血阻络证、肾精不足证两组24 h平均收缩压(24 h SBP)高于其他三组,差异有统计学(P<0.05);肾精不足证组24 h平均舒张压(24 h DBP)高于其他组。肾精不足证、瘀血阻络证组24 h收缩压标准差(24 hSBP-SD)均明显大于其他证型组;各证型组24 h舒张压标准差(24 h DBP-SD)比较差异均无统计学意义。结论老年高血压患者以肾精不足和瘀血阻络两证型多见;血压变异性可作为老年高血压部分中医证型的辨证参考依据。

Objective To explore the correlation between Chinese medicine differentiated types of elderly primary hypertension and blood pressure variability so as to provide the objective standards for the pattern/syndrome differentiation of elderly primary hypertension. Methods The 24 h dynamic blood pressure detection technique was applied to monitor blood pressure of 103 cases of enrolled elderly primary hyperten- sion. The cases were differentiated based on Chinese medicine. The dynamic blood pressure data were ob- served in each differentiated pattern/syndrome. Results （ 1 ） Kidney essence insufficiency of elderly primary hypertension occupied the highest proportion, indicating the statistical significance as compared with the other patterns/syndromes. （2）The 24 h SBP in the groups of collateral blood stagnation and kidney essence insuffi- ciency was higher than the other three groups, presenting the statistical difference （P 〈 O. 05 ）. The 24 h DBP in the group of kidney essence insufficiency was higher than the other groups. The 24 h SBP - SD in the groups of collateral blood stagnation and kidney essence insufficiency was bigger apparently than the other groups. The differences in 24 h DBP - SD were not significant statistically in comparison among groups. Con- clusion The kidney essence insufficiency and collateral blood stagnation are the most common patterns/syn- dromes of elderly hypertension. Blood pressure variability can be taken as the reference evidence for the pat- tern/syndrome differentiation of traditional Chinese medicine.