老年高血压合并心力衰竭中医证素特点分析

Characteristics of TCM Syndromes Elements of Senile Hypertension and Heart Failure

目的:调查上海地区老年高血压合并心力衰竭的中医证素分布特征。方法:采用流行病学横断面调查研究,采集上海地区364例老年高血压合并心力衰竭病人,采用中医证素调查表,对病人一般信息、心功能分级、中医症候特征等信息进行采集。结果:老年高血压合并心力衰竭的单一证素以血瘀、气虚为主;虚证中气虚阳虚为最常见的组合,实证中血瘀、痰浊为最常见的组合;血瘀证素在不同心功能分级的比例均超过半数;射血分数高者,以实证血瘀、痰浊、气滞为主;射血分数越低,证素以气虚、阳虚、阴虚虚症为主。结论:老年高血压合并心力衰竭病机特点为本虚标实,气虚为本,血瘀为标,气虚血瘀是老年高血压合并心力衰竭的发病基础。

Objective:To investigate the distribution characteristics of traditional Chinese medicine(TCM)syndrome factors of elderly hypertension complicated with heart failure in Shanghai.Methods:A cross-sectional epidemiological survey was used to collect 364 elderly patients with hypertension and heart failure in Shanghai area,and a TCM syndrome questionnaire was used to collect information on the patients,such as general information,cardiac function classification,and TCM syndrome factors.Results:Blood stasis and Qi deficiency were the main single syndromes of elderly hypertension combined with heart failure.Qi deficiency and Yang deficiency was the most common combination,followed by blood stasis and phlegm turbidity.The proportion of blood stasis syndrome element in different cardiac function grades was more than 50%.The higher the LVEF,the more evidence of blood stasis,phlegm,and Qi stagnation.The lower the LVEF,the more syndrome elements of Qi deficiency,Yang deficiency,and Yin deficiency.Conclusion:The core pathogenesis is Qi deficiency and blood stasis of elderly hypertension complicated with heart failure,the root cause of this disease is deficiency of Qi,while blood stasis is the symptom.Qi deficiency and blood stasis is the basis of the pathogenesis of senile hypertension complicated by heart failure.