443例原发性高血压中医证型分布及血压变异性规律研究

Study on TCM Syndrome Distribution and Blood Pressure Variability in 443 Patients with Primary Hypertension

目的探讨原发性高血压中医证型分布及血压变异性规律。方法选取443名原发性高血压病患者,采集四诊资料,进行辨证(复合证型者取主证),监测24 h动态血压,比较不同证型血压变异性。结果 443例患者中,肝肾阴虚证(157例)>气阴两虚证(83例)>阳气虚衰证(76例)>痰湿壅盛证(65例)>肝阳上亢证(62例)。不同证型年龄差异有统计学意义(P<0.05),性别、家族史、病程比较差异无统计学意义(P>0.05)。与肝肾阴虚证比较,痰湿壅盛证24 h收缩压、24 h平均血压差异有统计学意义(P<0.05);肝肾阴虚、肝阳上亢、气阴两虚、痰湿壅盛、阳气虚衰昼夜节律异常率分别为80.85%(38/47)、66.67%(14/21)、81.48%(22/27)、86.96%(20/23)、78.79%(26/33),各证型比较差异无统计学意义(χ~2=3.031,P=0.553)。结论 443名高血压患者中肝肾阴虚证最多,肝阳上亢证最少;痰湿壅盛证血压最高,肝阳上亢证血压最低;肝肾阴虚证血压变异性最高,气阴两虚证血压变异性最低。

Objective To study the TCM syndrome distribution and the laws of blood pressure variability in patients with primary hypertension. Methods Totally 443 patients with primary hypertension were selected; four diagnostic data were collected to conduct syndrome differentiation （main syndrome was chosen for compound syndrome）; 24 h ambulatory blood pressure was monitored and blood pressure variability of each syndrome was compared. Results Among 443 cases of patients, liver-kidney yin deficiency syndrome （157 cases） 〉 qi yin deficiency syndrome （83 cases） 〉 yang deficiency syndrome （76 cases） 〉 phlegm dampness syndrome （65 cases） 〉 liver yang hyperactivity syndrome （62 cases）. There was statistical significance in ages of different syndromes, but there was no statistical significance in gender, family history and course of disease （P〉0.05）. Compared with liver-kidney yin deficiency syndrome, 24 h systolic blood pressure and 24 h mean blood pressure of phlegm dampness syndrome were significantly different （P〈0.05）; circadian rhythm abnormality rates of liver-kidney yin deficiency syndrome, liver yang hyperactivity syndrome, qi yin deficiency syndrome, phlegm dampness syndrome and yang deficiency syndrome were 80.85% （38/47）, 66.67% （14/21） ,81.48% （22/27）, 86.96% （20/23）, and 78.79% （26/33）, respectively, without statistical significance in different syndromes （χ2=3.031, P=0.553）. Conclusion Among the 443 hypertensivepatients, patients with liver-kidney yin deficiency syndrome were the most, and patients with liveryang hyperactivity syndrome were the least. Phlegm dampness syndrome has the highest blood pressure, while liveryang hyperactivity syndrome has the lowest blood pressure. Patients with liver-kidney yin deficiency syndrome are with the highest blood pressure variability, while patients with qi yin deficiency syndrome are with the lowest blood pressure variability.