原发性高血压患者血压变异性与中医体质关系的研究探讨

Correlation of blood pressure variability and constitution of Traditional Chinese Medicine in patients with primary hypertension

目的研究探讨原发性高血压患者的血压变异性(BPV)与中医体质分类之间的关系。方法选取符合纳入标准的原发性高血压门诊患者(以下简称高血压门诊组)150例,住院患者(以下简称高血压住院组)200例,并在社区居民及门诊患者中筛选血压正常者50例。高血压门诊组患者及血压正常者均以1年为观察期,随访平时血压共3次,统计长时BPV[包括收缩压变异性(SBPV)及舒张压变异性(DBPV)]情况。高血压住院组患者进行24 h动态血压监测,每日记录3次血压,共观察1周,统计患者第1 d及1周的短时BPV情况。同时对住院患者不同证型间进行分析,比较不同证型之间的BPV(包括SBPV及DBPV)。入组后检测各组血液指标水平,包括血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及血尿酸(UA)。结果血压正常平和质者与高血压门诊组平和质患者的SBPV、DBPV及TC比较差异有统计学意义(P<0.05);高血压住院组痰湿质患者与其他体质之间仅1周DBPV比较差异有统计学意义(P<0.05);高血压住院组痰浊上蒙型及痰瘀互结型患者与其他证型之间仅1周DBPV比较差异有统计学意义(P<0.05)。结论原发性高血压平和质患者BPV水平较血压正常平和质者大,短时DBPV与痰湿质有相关性,血瘀亦可能参与了高血压的DBPV。

Objective To study the correlation of blood pressure variability （BPV） and constitution of Traditional Chinese Medicine （TCM） in patients with primary hypertension. Methods According to the inclusion criteria,we had coilected 150 outpatients with primary hypertension （outpatients gorup）, 200 inpatients with primary hypertension （inpatients group） and 50 normotensive in community （normal gorup）. The observation cycle was 1 year in outpatient and normal groups, 3 times of routine blood pressure was deteced druing follow - up, the long - time BPV including systolic blood pressure variability （SBPV） and diastolic blood pressure variability （DBPV） were observed. The inpatients group received 24 h ambulatory blood pressure monitory, blood pressure was recorded 3 times per day for 1 weeks, and then the short - time BPV at the frist day and one week were observed. The SBPV and DBPV of differencet TCM constitutions were analyzed in inpatients. The serum total Cholesterol （ TC）, triglyceride （TG） , low- density lipoprotein （LDL- C） , high- density lipoprotein （HDL- C） and serum uric acid （UA） were detected in all groups. Results There were statistical differences on SBPV, DBPV and TC in subjects with mild physical between normal and outpatients groups （ P 〈 0.05 ） . There was statistical difference only on DBPV at one week between phlegm - dampness and other constitutions in inpatients group （ P 〈 0.05 ）. There were statistical differences only on DBPV at one week among phlegm turbidity syndrome, turbid phlegm and blood stasis syndrome and other syndrome in inpatients group （P 〈0.05 ）. Conclusion Primay hypertension of mild physical constitution has greater BPV than nornal hypertnsion of mild physical constitution, and the short - time DBPV has correlation with phlegm - dampness constitution, and the blood stasis may be paly a role in DBPV in hypertension.