脑卒中高危人群高血压患者中医证候要素特点探究

TCM Syndrome and Factors of High Risk Population of Stoke with Hypertension

目的:探讨脑卒中高危人群高血压患者证候要素分布特点,为该人群的辨证论治提供参考。方法:选取2013—2014年北京市丰台区卢沟桥、兴隆社区卫生服务中心筛查的脑卒中高危人群中符合高血压合并多种卒中风险标准患者739例,按既往血压最高水平分为1、2、3级,卒中风险参照《2011年医改重大专项国家脑卒中高危人群筛查及干预试点项目实施方案》脑卒中高危人群入组标准,收集中医四诊信息,运用因子分析方法,提取证候要素,探讨其分布特点。结果:脑卒中高危人群高血压患者主要证候要素为气虚(16.0%)、阴虚(14.6%)、火(14.6%)、阳虚(11.0%),虚证占52.8%,痰湿、血瘀为常见兼夹因素,病位在肝、脾、肾;不同级别高血压分组中气虚、阴虚均为出现频率较高的证候要素,火在1级、3级人群中分布较高。结论:脑卒中高危人群高血压患者中医证候要素分布以气血阴阳亏虚为本,痰湿、血瘀贯穿疾病各阶段,火证表现明显。

Objective： To observe the syndrome factors of high risk group of stroke and hypertension,so as to provide support for Traditional Chinese Medicine（ TCM） syndrome differentiation and treatment. Methods： A total of 739 patients conforming to the criteria of the high risk of stroke population and hypertension were selected from Beijing Lugouqiao and Xinglong community health service centers,then were divided into three levels,I,II,III according to the levels of blood pressure. Risk of stroke was in reference to the reform of ＂2011 Major Projects National Stroke High-risk Population Screening and Intervention Pilot Project＂. The syndrome factors were extracted with factor analysis. Results： The main syndrome factors of the 739 patients were as follows： qi deficiency（ 16. 0%）,yin deficiency（ 14. 6%）,fire heat（ 14. 6%）,yang deficiency（ 11. 0%）. Among them,deficiency syndrome（ 52. 8%） is the most common one,and phlegm and blood stasis are also frequent to be seen. Qi deficiency and yin deficiency were high frequency syndrome factors in all levels of hypertension. The fire heat syndrome distribution was higher in level I and level III. Conclusion： Among high risk populations with hypertension,blood,qi,yin or yang deficiency are the root cause of such disease,and dampness and stasis are the manifestations of all stages. Fire heat is the most obvious symptom.