高血压病中医病性证素分布与心肺功能相关性研究

Study on the correlation between the distribution of TCM pathological evidence elements and cardiopulmonary function in hypertension

目的探讨高血压病中医病性证素分布规律及其与心肺功能相关指标的关系。方法回顾性收集2019年1月-2021年10月青岛市中医医院心血管一科149例行心肺运动试验(CPET)检查的3级高血压病患者相关资料,并依据《证素辨证学》相关内容进行病性证素判定。采用χ^(2)检验分析各病性证素间心肺功能的差异,采用Spearman相关性分析探讨病性证素与心肺功能的相关性。结果149例高血压病患者病性证素的出现频率由高到低依次为痰、阴虚、湿、阳亢、血虚、血瘀、气虚、阳虚、气滞、热、食积、动风、脓。各病性证素间心肺功能指标无明显差异(P>0.05)。Spearman相关性分析显示,阴虚证素与峰值氧脉搏(Peak O2 pulse)呈负相关(r=-0.213,P=0.009),血瘀证素与峰值摄氧量(Peak VO2)(r=-0.170,P=0.039)、Peak O2 pulse(r=-0.192,P=0.019)呈负相关,痰证素与无氧阈(AT)(r=-0.192,P=0.019)呈负相关。结论高血压病中医病性证素主要集中于痰、阴虚、湿、阳亢,病性证素与心肺功能相关指标存在一定的关联性,可为中医临床治疗高血压病提供参考。

Objective To explore the correlation of distribution pattern of TCM pathological evidence of hypertension with the related indexes of cardiopulmonary function.Methods From January 2019 to October 2021,the relevant data of 149 patients with grade 3 hypertension who underwent CPET examination in the Department of Cardiology,Qingdao Hospital of Traditional Chinese Medicine were retrospectively collected,and the pathogenic factors were determined according to the relevant content of"Dialectic of Evidence".The Chi-square test was used to analyze the difference of cardiopulmonary function between the pathological factors,and the Spearman correlation analysis was used to explore the correlation between pathological factors and cardiopulmonary function.Results The pathogenic factors of 149 hypertensive patients from high to low,are as follows were phlegm,yin deficiency,dampness,yang hyperactivity,blood deficiency,blood stasis,qi deficiency,yang deficiency,qi stagnation,heat,food accumulation,moving wind,pus.There was no statistical significance among the pathological factors(P>0.05).Spearman correlation analysis showed that Yin deficiency syndrome was negatively correlated with Peak O2 pulse(r=-0.213,P=0.009),blood stasis was negatively correlated with Peak VO2(r=-0.170,P=0.039)and Peak O2 pulse(r=-0.192,P=0.019),and phlegm syndrome hormone was negatively correlated with anaerobic threshold(AT)(r=-0.192,P=0.019).Conclusions TCM pathogenic factors in hypertension mainly focus on phlegm,Yin deficiency,dampness and yang hyperactivity.There is a certain correlation between pathogenic factors and cardiopulmonary function-related indicators,which can provide reference for the clinical treatment of hypertension in TCM.