盐敏感性高血压病不同中医证候间血压特点、差异及心率变异性研究

A study on heart rate variability,the characteristics and differences of blood pressure among different TCM syndromes of salt-sensitive hypertension

目的:研究观察盐敏感性高血压病患者不同中医证候间的血压特点、差异及心率变异性影响。方法:选取2017年10月-2018年10月我院收治的110例盐敏感性高血压病患者为本次研究对象,根据不同中医证候将其分为三组,分别为A组(阴虚阳亢证,20例)、B组(痰湿壅盛证,30例)、C组(脾肾阳虚、水饮内停证,60例),采用动态心电图、动态血压对不同中医证候患者血压、心率进行检测,并对比其差异与变异性。结果:C组患者24 h平均收缩压(24 h ASBP)、夜间平均收缩压(NASBP)、日间平均收缩压(DASBP)指标更高于A、B组,24 h收缩压负荷(24 h SBPL)、夜间收缩压负荷(NSBPL)、日间收缩压负荷(DSBPL)、24 h舒张压负荷(24 h DBPL)、夜间舒张压负荷(NDBPL)、日间舒张压负荷(DDBPL)及24 h收缩压变异系数(24 h SBPV)、夜间收缩压变异系数(NSBPV)、24 h舒张压变异系数(24 h DBPV)、夜间舒张压变异系数(NDBPV)、日间舒张压变异系数(DDBPV)指标与A组比较更高,差异有统计学意义(P<0.05)。C组患者24h RR间期标准差(SDNN)、每5mins正常RR间期平均值标准值(SDANN)相比A、B组指标更低,差异有统计学意义(P<0.05);但不同证型组间相邻正常RR间期差值>50 ms计数占总RR间期百分比(PNN50)与相邻正常RR间期差值均方根(RMSSD)指标则差异不大,差异无统计学意义(P>0.05)。结论:通过对盐敏感性高血压病患者不同中医证候间的血压特点、差异及心率变异性的分析,可为病情判断、临床治疗工作提供科学指导。

Objective:To investigate heart rate variability,the characteristics and differences of blood pressure among different TCM syndromes of salt-sensitive hypertension.Methods:October 2017-October 2018,110 cases were divided into 3 groups,with 20 cases of the Yinxu Yangkang syndrome(阴虚阳亢证)in the group A,30 cases of the Tanshi Yongsheng syndrome(痰湿壅盛证)in the group B,60 cases of the Pishen Yangxu and Shuiyin Neiting syndrome(脾肾阳虚、水饮内停证)in the group C.The blood pressure and heart rate of patients with different TCM syndromes were tested by dynamic electrocardiogram and ambulatory blood pressure,and the differences and variability were compared.Results:The 24 h ASBP,NASBP and DASBP indicators in group C were higher than those in groups A and B;24 h SBPL,NSBPL,DSBPL,24 h DBPL,NDBPL,DDBPL and 24 h SBPV,DSBPV,24 h DBPV,NDBPV,DDBPV were higher than group A(P<0.05).The SDN and SDANN of group C were lower than those of group A and group B,and the difference was statistically significant(P<0.05).There was no significant difference between the different syndrome types of PNN50 and RMSSD in each group(P>0.05).Conclusion:Through the analysis of blood pressure characteristics,differences and heart rate variability among different TCM syndromes in salt-sensitive hypertensive patients,it can provide scientific guidance for disease judgment and clinical treatment.