120例H型高血压中医证素及证型研究

Study on Traditional Chinese Medicine Syndrome Elements and Types in 120 Cases of H-Hypertension

目的 :研究H型高血压的中医证素及证型分布特点,为H型高血压标准化诊断及分证论治提供理论依据。方法 :选取2014年10月到2015年10月盐城市中医院85岁以下H型高血压患者120例,设计问卷调查表,对纳入对象进行中医四诊信息采集,录入Epidata软件系统,校验导出;SPSS Statistics因子分析法分析数据,结合中医临床及专家意见,归纳H型高血压的中医证候要素及证型。结果:因子分析四诊信息,F1-肝火亢盛证:脉弦数、面红赤、目赤、急躁易怒、小便短黄、苔黄、口苦、舌红、耳鸣;F3-阴虚阳亢证:五心烦热、目涩、颧红、腰膝酸软、多梦、少津、头重脚轻、耳鸣、目胀、舌红、口干、苔少;F2-痰湿壅盛证:口黏腻、苔腻、头重如裹、舌淡胖有齿痕、痰色白、痰多、痰质稀、脉滑、苔白、泛恶欲吐、食少。结论:H型高血压中医病性证素:阴虚、阳亢、阳虚、火、痰、血瘀;病位证素:肝、脾、肾。中医证型:肝火亢盛证、阴虚阳亢证、痰湿壅盛证。

Objective：To study the traditional Chinese medieine（TCM） syndrome elements and types of H-hypertension,and to provide a scientific theoretical basis for TCM standardized diagnosis and syndrome differentiation of H-hypertension. Methods：From October 2014 to October 2015,120 cases of H-hypertension patients under the age of 85 years were enlisted,and were given the questionnaire to collect TCM four diagnostic information. The obtained data were input into Epidata software. Factorial analysis of SPSS were applied,and the TCM syndrome elements and types of H-hypertension were summarized by in combination with TCM clinical experts. Results：Through factor analysis for four diagnosis,there are 3 syndrome patterns as follows：Fl：exuberant liver fire：stringy and rapid pulse,red face and eyes,restlessness and irritability,scanty and yellow urine,yellow tongue coating,bitter taste in the mouth,red tongue and tinnitus;F2：excessive phlegm dampness：sticky and greasy sensation in the mouth ,greasy tongue coating,heaviness of the head with a feeling that the head is tightly wrapped,swollen and pale tongue with teeth marks on its margin,white, profuse and diluted sputum, slippery pulse,white tongue coating,nausea,poor appetite ; F3 ：deficient yin deficiency and excessive yang：feverish sensation in the five centers,dry eyes,red cheeks,hectic cheek,soreness and weakness of loins and knees ,dreaminess ,insufficiency of body fluid,heavy sensation of the head ,tinni- tus,distending eyes,red tongue,dry mouth,little tongue coating. Conclusion：The property elements of H-hypertension are yin deficiency,hyperactivity of yang,yang deficiency,fire,phlegm and blood stasis;position elements are liver,spleen,kidney;syndrome types are liver fire hyperaetivity,yin deficiency and yang hyperactivity,excessive phlegm dampness.