老年原发性高血压中医证型与血脂及生存质量研究

Relationship between TCM Syndrome and Blood Lipid,Quality of Life in Elderly Hypertension Patients

目的探讨肝火亢胜、痰湿壅盛、阴虚阳亢、阴阳两虚型老年高血压患者的血脂及生存质量水平的关系。方法对所有纳入研究的高血压患者进行中医辨证分型,并记录年龄,测定肥胖指数、脉压、总胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白、C反应蛋白、凝血功能等。采用生存质量量表进行问卷调查,测算心理领域、独立性领域、生理领域、社会关系领域计分,对不同中医证型组患者的生物学指标和生存质量计分进行方差分析。结果痰湿壅盛组的体重指数较大,与阴虚阳亢组比较有统计学意义(P<0.05),阴阳两虚组的脉压较大,与肝火亢胜组比较有统计学意义(P<0.05)。痰湿壅盛组的总胆固醇指标较高,与肝火亢盛组及阴虚阳亢组比较有统计学意义(P<0.05)。痰湿壅盛组的高密度胆固醇指标较高,与阴虚阳亢组比较均有统计学意义(P<0.05);阴阳两虚组的活化部分凝血酶时间较短,与痰湿壅盛组比较有统计学意义(P<0.05);痰湿壅盛组的心理性评分较高,并与阴阳两虚组比较有统计学意义(P<0.05);阴阳两虚组社会交往评分较低,与阴虚阳亢组比较有统计学意义(P<0.05);阴阳两虚组幸福指数较低,与阴虚阳亢组比较有统计学意义(P<0.05)。结论不同中医证型的老年高血压患者血脂及生存质量评分存在差异,阴阳两虚患者脉压较大,心理性评分较低,社会交往能力下降,幸福指数最低,治疗上应有相应重点。

Objective To investigate the relationship between traditional Chinese medicine（TCM） syndrome and blood lipid,quail ty of life in elderly patients with hypertension. Methods Syndrome differentiation, age, obesity index, pulse pressure, total cholester ol, glycerin three greases, high density lipoprotein,low density lipoprotein cholesterol, C - reactive protein, blood coagulation function were recorded. The psychological domain score, independent domain score, physiological domain scores, social relationships domain, bi- ological index,and score of quality of life were analyzed in different TCM syndromes. Results There was greater body mass index in phlegm syndrome group,it was significant difference compared with that in yang hyperactivity due to yin deficiency syndrome group （P〈（0.05）. The pulse pressure in deficiency syndrome of yin and yang group was significantly different compared with that in liver- fire hyperactivity syndrome group（P〈0.05）. Total cholesterol index in phlegm - dampness syndrome group were higher than that in flaring liver- fire hyperactivity syndrome and yang hyperactivity due to yin deficiency syndrome group（P〈0.05）. The high density cholesterol index in phlegm dampness syndrome group was significant difference compared with hyperactivity of yang due to yin defi- ciency syndrome group（P〈0.05）. Psychological score in phlegm--dampness syndrome group was higher compared with that in yin and yang deficiency syndrome group （P〈0.05）. The happiness index in yin and yang deficiency syndrome group was low than that in hyperactivity of yang due to yin deficiency syndrome group（P〈0. 05）. Conclusion Serum lipid and survival quality score were differ- ent in TCM syndromes in elderly hypertensive patients. Pulse pressure difference was larger in patients with yin and yang deficiency syndrome group. Its psychological score was lower and the happiness index was the lowest.