| 引用本文: |
龙远雄,雍苏南.高血压病合并冠心病患者中医证型分布特征与危险因素分析[J].湖南中医药大学学报,2021,41(2):291-295[点击复制] |
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| 高血压病合并冠心病患者中医证型分布特征与危险因素分析 |
| 龙远雄,雍苏南 |
| (湖南中医药大学第一附属医院, 湖南 长沙 410007) |
| 摘要: |
| 目的 探索高血压病合并冠心病中医证型分布特征与危险因素。方法 回顾性分析我院762例高血压患者病历资料，并按是否合并冠心病进行分组，记录各组患者一般资料与实验室检测指标，应用χ2检验、秩和检验与Logistic回归等统计学方法对其中医证型分布规律与危险因素进行分析。结果 高血压合并冠心病的中医证型以阴虚阳亢、瘀血阻络为主；多因素Logistic回归结果显示：年龄大、体质量指数>24 kg/m2、有吸烟史、有糖尿病史、血尿酸高、血同型半胱氨酸（homocysteine，Hcy）高、平均血小板体积（MPV）高、血小板体积分布宽度（PDW）高是高血压患者合并冠心病的危险因素，高密度脂蛋白胆固醇（high density lipoprotein cholesterol，HDL-C）高为保护因素，其中低密度脂蛋白胆固醇（low density lipoprotein cholesterol，LDL-C）水平也是阴虚阳亢证发生的保护因素、Hcy为阴虚阳亢证发生的危险因素，有吸烟史、MPV、PDW为瘀血阻络证发生的危险因素。结论 高血压病合并冠心病以阴虚阳亢、瘀血阻络为主要病机；减少吸烟（特别是高龄高血压患者），保持正常体质量，并定期做好肌酐、血尿酸、Hcy等指标监控，可以降低高血压合并冠心病的发病风险。 |
| 关键词: 高血压 冠心病 中医证型 危险因素 |
| DOI：10.3969/j.issn.1674-070X.2021.02.024 |
| 投稿时间：2020-06-28 |
| 基金项目:国家自然科学基金青年基金（81804077）；湖南省自然科学基金青年基金（2019JJ50468）；国家中医药管理局中医药部门公共卫生专项“中医药防治重大疑难疾病服务能力建设”（2100409）；湖南中医药大学中医学国内一流建设学科。 |
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| Analysis of Distribution Characteristics of Traditional Chinese Medicine Syndrome Types in Patients with Hypertension Combined with Coronary Heart Disease and Risk Factors |
| LONG Yuanxiong,YONG Su'nan |
| (The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China) |
| Abstract: |
| Objective To explore the distribution characteristics of traditional Chinese medicine (TCM) syndrome types of hypertension combined with coronary heart disease and its possible risk factors. Methods The data of 762 patients with hypertension in our hospital were analyzed retrospectively. The patients were divided into groups according to whether they were combined with coronary heart disease or not. The general data and laboratory test indexes of each group were recorded. The distribution of TCM syndrome types and risk factors were analyzed by chi-square, rank sum test and Logistic regression. Results The TCM syndromes of hypertension with coronary heart disease were mainly Yin deficiency and Yang hyperactivity, blood stasis and collaterals obstruction. Multivariate Logistic regression results showed that age, body mass index (>24 kg/m2), smoking history, diabetes history, high blood uric acid, high blood homocysteine (Hcy), high mean platelet volume (MPV) and high width of platelet volume distribution (PDW) were risk factors for hypertension patients with coronary heart disease, and high density lipoprotein cholesterol (HDL-C) was the protective factor, among them, low density lipoprotein cholesterol (LDL-C) level was also a protective factor for the occurrence of syndrome of Yin deficiency and Yang hyperactivity, Hcy was a risk factor for the occurrence of syndrome of Yin deficiency and Yang hyperactivity, and smoking history, MPV and PDW were risk factors for the occurrence of syndrome of blood stasis. Conclusion The main pathogenesis of hypertension combined with coronary heart disease is Yin deficiency and Yang hyperactivity, blood stasis and collaterals obstruction; reduce smoking (especially the elderly patients with hypertension), maintain normal body mass, and regularly monitor indexes such as creatinine, blood uric acid and Hcy can reduce the risk of hypertension combined with coronary heart disease. |
| Key words: hypertension coronary heart disease traditional Chinese medicine syndrome type risk factors |
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