原发性高血压病人中医体质特点及相关影响因素分析

Analysis of TCM Constitution and Related Factors in Patients with Essential Hypertension

目的分析原发性高血压病人中医体质情况及相关影响因素。方法选取2019年8月—2020年7月在广东省中医院大学城分院综合二科住院的高血压病人186例,观察中医体质分布情况,血尿酸、低密度脂蛋白胆固醇(LDL-C)、同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)等实验室指标,以及脉搏波传导速度(baPWV)、颈动脉内膜中层厚度(IMT)及斑块等血管功能指标,观察高血压分级和心血管危险分层情况。结果186例病人中,中医体质构成以偏颇体质为主,为142例(76.3%),偏颇体质中以痰湿质最多,共35例,且老年高血压组痰湿质占比高于中青年高血压组(P<0.05)。高血压3级及心血管风险分层为很高危病人痰湿质比例最高,分别占23.2%、21.2%。高血压合并脑卒中的病人以痰湿质最多,占57.1%。非条件逐步Logistic回归分析显示,脑卒中及左侧颈动脉IMT是痰湿质的危险因素。有无痰湿质高血压病人体质指数、左侧颈动脉IMT比较差异均有统计学意义(P<0.05)。结论高血压病人中医体质构成以偏颇体质为主,其中痰湿质比例最高。痰湿质与年龄、高血压分级、心血管危险分层、BMI、左侧颈动脉IMT、脑卒中有关。

Objective To explore the relationship between the physical condition of traditional Chinese medicine and clinical related factors in patients with essential hypertension.Methods One hundred and eighty-six hypertensive patients who were hospitalized in the Second Department of Comprehensive Department of University Town Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine from August 2019 to July 2020 were selected.The physical condition of traditional Chinese medicine,the blood uric acid(BUA),low-density lipoprotein cholesterol(LDL-C),homocysteine(Hcy),high-sensitivity C-reactive protein(hs-CRP),pulse wave velocity(baPWV),carotid artery intima-media thickness(IMT),plaque,the classification of hypertension,and cardiovascular risk stratification were observed.Results Among the 186 patients,the constitution of the TCM physique mainly biased physique(142 cases,76.3%).Among the biased constitutions,the phlegm dampness constitution was the most one(35 cases),and the proportion of phlegm dampness constitution in the elderly hypertension group was higher than that in the young and middle-aged hypertension group(P<0.05).Patients with hypertension grade 3 and cardiovascular risk stratified as high-risk group complicated the highest proportion of phlegm-damp quality,accounting for 23.2%and 21.2%,respectively.Patients with hypertension and stroke complicated the most phlegm and dampness(57.1%).Patients with Phlegm-damp constitution has a certain correlation with left carotid artery IM T and stroke.There were statistically significant differences in body mass index(BMI)and left carotid artery IMT in hypertension patients with or without phlegm-dampness(P<0.05).Conclusion The constitution of traditional Chinese medicine in patients with hypertension is mainly biased,with the highest proportion of phlegm-dampness.The distribution of phlegm and dampness is related to age,stage of hypertension,cardiovascular risk stratification,BMI,left carotid atherosclerosis,and stroke.