北京市西城区某社区2021年老年健康体检高血压患者中医体质类型分析

Analysis of TCM Constitution of Elderly Healthy Patients with Hypertension Underwent Physical Examination in 2021 in a Community of Beijing Xicheng District

目的:分析北京市西城区广内社区卫生服务中心某社区站2021年老年体检中高血压患者中医体质,探讨中医体质类型与高血压发病可能存在的关系。方法:选取2021年1-12月在广内社区卫生服务中心某社区站完成健康体检的年龄≥65岁的老年高血压患者459例为研究对象,对患者进行中医体质辨识,比较该社区老年高血压患者不同中医体质间的差异。结果:459例老年高血压患者中,男性204例(44.4%),女性255例(55.6%),合并有2型糖尿病174例(37.9%),合并有其他慢病患者299例(65.1%)。中医体质辨识以痰湿质和阴虚质比例最高,分别占31.6%、31.4%。合并2型糖尿病的高血压患者中痰湿质、阴虚质、血瘀质患者高于其他体质患者,合并冠心病的高血压患者中阴虚质、痰湿质、血瘀质患者高于其他体质患者,合并脑血管病的高血压患者中痰湿质、阴虚质、平和质患者高于其他体质患者,吸烟的高血压患者中以痰湿质、阴虚质、平和质患者高于其他体质患者,差异具有统计学意义(P<0.05)。结论:痰湿质和阴虚质是社区老年高血压患者较常见的体质类型。社区慢病管理团队中中医师可针对高血压患者不同中医体质类型,制定个性化的健康宣教和干预方案,发挥中医药非药物管理优势,更好地发挥中医辨证论治、个体化及“治未病”的优势,提高社区高血压的管理率和达标率。

Objective:To analyze the traditional Chinese medicine constitution of hypertension patients in a community station of Guangnei Community Health Service Center in Xicheng District,Beijing in 2021,to discuss the possible relationship between the types of traditional Chinese medicine constitutionality and hypertension.Methods:A total of four hundred and fifty-nine elderly hypertension patients aged≥65 years who completed physical examination in a community station of Xicheng District Guangnei Community Health Service Center from January to December 2021 were selected as research objects,and TCM constitution identification was carried out on the patients.The difference of different constitutions of traditional Chinese medicine among the elderly hypertension patients in this community was compared.Results:Among four hundred and fifty-nine elderly patients with hypertension,two hundred and four cases(44.4%)were male,two hundred and fifty-five cases(55.6%)were female,one hundred and seventy-four cases(37.9%)were combined with type 2 diabetes and two hundred and ninety-nine cases(65.1%)were combined with other chronic diseases.The proportion of phlegm-dampness and yin deficiency was the highest,accounting for 31.6%and 31.4%respectively.Patients with hypertension combined with type 2 diabetes had higher phlegm-dampness,yindeficiency and blood-stasis than other patients.Patients with hypertension combined with coronary heart disease had higher phlegm-dampness,yin-deficiency and blood-stasis than other patients.Patients with hypertension combined with cerebrovascular disease had higher phlegm-dampness,yin-deficiency and blood-stasis than other patients.Patients with smoking had higher phlegm-dampness,yin-deficiency and blood-stasis than other patients.The difference was statistically significant(P<0.05).Conclusion:Phlegm-dampness and Yin deficiency are common physical types of elderly hypertension patients in community.TCM doctors in the community chronic disease management team can formulate personalized health education and intervention programs for hypertension patients with different TCM constitution types,give full play to the advantages of TCM nondrug management,and better play to the advantages of TCM syndrome differentiation,individuation and"disease prevention",so as to improve the management rate of hypertension in the community and the rate of meeting the standards.