中老年高血压证候分布规律及其相关因素分析

Analysis of the Distribution of Hypertension Syndrome and Its Related Factors in Middle and Old Age

目的:分析中老年高血压中医证候分布规律与其相关因素之间的关系。方法:系统随机抽取长沙市5个社区,筛选符合高血压病诊断标准的398例中老年高血压患者,参照《中药新药临床研究指导原则》等中医证候分型标准,对其四诊信息进行辨证分型,并收集其人口学资料、血压水平、病程、症状/体征等资料,采集血标本检测血脂、内皮素、外周儿茶酚胺(CA)与血浆雌二醇(E_2),观察中医证候分布规律并对中医证候与相关危险因素进行相关性分析。结果:398例中老年高血压患者中,出现频率最高的前10位症状依次为眩晕、头痛、失眠多梦、夜尿频、耳鸣、腰酸、急躁易怒、口干、心悸与健忘,中医证型构成比>10%的证型依次为阴虚阳亢证、肝火亢盛证、阴阳两虚证、痰湿壅盛证和瘀血阻络证,不同证型分布患者的年龄、高血压病程与舌下脉络存在差异,且以阴虚阳亢证、肝火亢盛证与瘀血阻络证危险因素之间差异更明显。结论:"虚、风、痰、瘀"贯穿长沙市中老年高血压病始终,虚、瘀、风证与其相关危险因素关系更为密切。

Objective： To observe the relevance between distributive regularities of TCM syndromes and their relative risk factors in middle and old aged patients with essential hypertension. Method： Randomly selected 5 communities of Changsha,398 patients meet the hypertension diagnosis criteria were screened,we classified TCM syndromes from four diagnostic information acccording to the Guiding Principle of Clinical Research on New Drugs of TCM. Besides,data like demography,blood pressure,life style and symptoms and signs were collected and blood samples were collected for detection of serum lipids,endothelin,peripheral catecholamines（ CA） and plasma estradiol（ E_2）. We study the relevance between distributive regularities of syndromes and and their relative risk factors from the data. Results： The top ten most common symptoms in 398 cases of elderly patients with hypertension were dizziness,headache,insomnia,night urination,tinnitus,backache,and irritability. The TCM pattern syndrome which constituent ratio is over 10% are followed by yin vacuity with yang hyperactivity pattern,exuberance of liver fire pattern,dual vacuity of yin and yang pattern,damp phlegm congestion pattern and pattern of static blood obstructing the network vessels. There are differences in the distribution of syndrome types in the age,disease course and different sublingual veins,especially in yin vacuity with yang hyperactivity pattern,exuberance of liver fire pattern and static blood obstructing the network vessels pattern. Conclusion： Excess syndrome takes the beginning stage in the morbidity of elderly patients with hypertension,then developed to deficiency syndrome; virtual,wind,phlegm and blood stasis stay throughout the middle and old aged hypertension patients in Changsha,while virtual,stasis,wind syndrome are much close with its related risk factors.