不同级别原发性高血压中期肾损害患者的中医脏腑辨证特点及临床意义

Characteristics and clinical significance of TCM visceral syndrome differentiation in patients with different grades of primary hypertensive mid-renal damage

目的探讨不同级别原发性高血压中期肾损害患者的中医脏腑辨证特点及临床意义。方法回顾性分析我院2018年3月至2019年6月收治的71例不同级别原发性高血压中期肾损害患者的临床资料,根据患者年龄的不同,分为≤50岁(n=14),51~70岁(n=41),>70岁(n=16),根据患者高血压级别的不同,分为Ⅰ级(n=17),Ⅱ级(n=38),Ⅲ级(n=16)。比较不同年龄段、不同级别原发性高血压中期肾损害患者的脏腑定位积分和气血阴阳辨证分类积分。结果>70岁原发性高血压中期肾损害患者的脏腑定位积分、气血阴阳辨证分类积分均明显高于其他年龄段的患者,且≤50岁的患者与51~70岁、>70岁患者的脏腑定位积分、气血阴阳辨证分类积分比较,差异均有统计学意义(P<0.05);Ⅲ级原发性高血压中期肾损害患者的脏腑定位积分、气血阴阳辨证分类积分均明显高于Ⅰ级、Ⅱ级患者,且Ⅰ级与Ⅱ级、Ⅲ级患者的脏腑定位积分、气血阴阳辨证分类积分比较,差异均有统计学意义(P<0.05)。结论原发性高血压中期肾损害患者的肾脏损害水平随着血压级别及年龄的增长而明显加重,且瘀血证、阴虚证程度也随之增加。

Objective To explore the characteristics and clinical significance of TCM visceral syndrome differentiation in patients with different grades of primary hypertensive mid-renal damage. Methods Seventy-one patients with different grades of primary hypertensive mid-renal damage treated in our hospital from March 2018 to June 2019 were enrolled in the retrospective analysis. Those patients were divided into the group of age ≤ 50 years old(n=14), the group of age between 51 and 70 years old(n=41), and the group of age>70 years old(n=16) according to the age;they were divided into grade Ⅰ(n=17), grade Ⅱ(n=38), and grade Ⅲ(n=16) according to the different grades of hypertension.The visceral positioning integral and syndrome differentiation classification integral of qi and blood and yin-yang in patient of different age groups and different grades of primary hypertensive mid-renal damage were analyzed and compared. Results The visceral positioning integral and syndrome differentiation classification integral of qi and blood and yin-yang in patients with primary hypertensive mid-renal damage in the group of age >70 years old were higher than those in other age groups.There were statistically significant differences in the visceral positioning integral and syndrome differentiation classification integral of qi and blood and yin-yang of patients in the group of age ≤50 years old,the group of age between 51 and 70 years old, and the group of age >70 years old(P<0.05). The visceral positioning integral and syndrome differentiation classification integral of qi and blood and yin-yang in patients with grade Ⅲ primary hypertensive mid-renal damage were significantly higher than those in patients with grade Ⅰand grade Ⅱ primary hypertensive mid-renal damage.There were statistically significant differences in the visceral positioning integral and syndrome differentiation classification integral of qi and blood and yin-yang of patients with grade Ⅰ, grade Ⅱ and grade Ⅲ primary hypertensive mid-renal damage(P<0.05). Conclusion With the increase of hypertension grade and age, the level of renal damage in patients with primary hypertensive mid-renal damage increases significantly, and the degree of blood stasis syndrome and Yin deficiency syndrome also increases.