原发性高血压中医证素分布及其与影响因素的相关性研究

Correlation between traditional Chinese medicine syndrome elements and relevant factors in essential hypertension

目的:分析原发性高血压患者(EH)的中医证素分布及其与影响因素的相关性。方法:采用临床横断面研究方法,收集EH患者的四诊信息及影响因素指标。运用逻辑回归分析等统计学方法进行相关性分析。结果:共纳入病例1 192例,涉及主要证素12种:肾、肝、心、脾;湿、阳亢、痰、火(热);气虚、阴虚、精亏、血虚。双因素组合出现较多的证素为肝+肾、痰+湿和气虚+阴虚;三因素组合证素出现较多的为肝+肾+心、阳亢+痰+湿和精亏+气虚+阴虚。60岁以下的女性患者与肾最相关,男性则为精亏;61-70岁的女性与心最相关,男性则为火(热);80岁以上的女性与火(热)最相关,男性则为痰。湿证与体质量指数(BMI)值正相关,阴虚则相反。阴虚和阳亢与血压等级正相关。肾、精亏和阳亢与高血压病史正相关。结论:原发性高血压中医证素的分布与患者的性别、年龄、体质量指数、高血压等级及高血压病史均具有统计学相关性。

Objective: To analyze the correlation between distribution law of traditional Chinese medicine syndrome elements(SEs) and relevant factors in patients with essential hypertension(EH).Methods: During a clinical cross-sectional survey,the four diagnostic information and relevant factors of EH patients were collected.Binary logistic regression analysis was used for correlation analysis.Results: Twelve SEs were involved in 1 192 EH patients,which were kidney,liver,heart,spleen,dampness,hyperactivity of yang,phlegm,fire(heat),qi deficiency,yin deficiency,deficiency of kidney essence,blood deficiency.More common multiple factors combination SEs were liver and kidney,phlegm and dampness,qi deficiency,yin deficiency,liver and kidney and heart,hyperactivity of yang and phlegm and dampness,deficiency of kidney essence and qi deficiency and yin deficiency.The female EH patients under 60 years oldtended to kidney,while the male patients to deficiency of kidney essence.The old women between 61 to 70 years old were related to heart,the men to fire(heat).The women over 80 years old tended to fire(heat),while the men to phlegm.Dampness was positively correlated with BMI,while yin deficiency was opposite.Yin deficiency and yang hyperactivity were positively correlated with blood pressure.Kidney,deficiency of kidney essence and yang hyperactivity were positively correlated with medical history.Conclusion: The distributions of SEs in EH patients were correlated with gender,age,body mass index,blood pressure and case history.