高血压肾损害患者临床现状调查及中医体质学研究

发布时间：2018-12-13 09:00

【摘要】：目的:研究高血压肾损害患者的临床现状、体质特点及分布情况,为防治高血压肾损害提供依据,同时为高血压肾损害的中医药个体化治疗提供参考。材料与方法:通过收集辽宁中医药大学附属医院肾内科91例高血压肾损害患者的一般资料、高血压情况及临床指标进行调查分析,并对纳入患者,进行中医体质问卷调查,探讨高血压肾损害患者的发病特征、诊疗状况及中医体质特点。结果:1、本次研究共纳入91例患者,其中男性55例,女性36例,男女比例为1.53:1,平均年龄64.95±12.91岁,以60-79岁居多。2、血压情况以3级高血压占多数,为82.42%;高血压出现肾损害时间间隔以11-20年居多,占30.77%;存在心血管损害占52.75%,脑血管损害占29.67%;存在心、脑、眼2种及以上靶器官损害的占69.45%;合并危险因素以高脂血症居多,占51.65%。3、应用降压药治疗者83例(91.21%),未应用降压药治疗者8例(8.79%),血压总体达标率63.74%;应用降压药血压达标者56例(67.47%),未达标者27例(32.53%);多数为2种以上降压药联合治疗。降压药使用频次以CCB类居多,其次是ARB类。4、高血压肾损害患者中医体质虚性体质居多(40.66%),单一偏颇体质以阳虚质、气虚质居多;兼夹体质当中主要是以两种体质兼夹为主;初步判定,高血压肾损害患者不同性别与体质分布无显著相关性。结论:高血压肾损害患者以老年人为主,男性多于女性,应重视老年高血压肾损害患者的宣教。高血压出现肾损害时间以11-20年居多,与普遍认为的“高血压持续5到10年即出现肾损害”并不相同。其与患者发病隐匿,临床多无特异症状,导致患者就诊延迟有关。多数患者已合并多种其他靶器官损害及糖、脂质代谢紊乱。治疗上,降压药物无论是单药,还是多药联合均以CCB类居多。高血压肾损害患者中医体质特点以虚性为主,同时存在兼夹体质。高血压肾损害是一种或多种体质共同参与发生发展的。
[Abstract]:Objective: to study the clinical status, physical characteristics and distribution of patients with hypertensive renal damage, to provide basis for prevention and treatment of hypertensive renal damage, and to provide reference for individualized treatment of hypertensive renal damage. Materials and methods: by collecting the general data, hypertension and clinical indexes of 91 patients with hypertensive renal damage in the affiliated Hospital of Liaoning University of traditional Chinese Medicine, we investigated and analyzed the physical constitution of traditional Chinese Medicine (TCM). To explore the characteristics of hypertension and renal damage, diagnosis and treatment and traditional Chinese medicine physique characteristics. Results: 1. A total of 91 patients were included in this study, including 55 males and 36 females, the ratio of male to female was 1.53: 1, the average age was 64.95 卤12.91 years old, the majority was 60-79 years old, and the blood pressure was mostly grade 3 hypertension. 82.42; The time interval of renal damage in hypertension was 11-20 years (30.7777), cardiovascular damage was 52.75, cerebrovascular damage 29.67 percent, heart, brain, eye and more than two kinds of target organ damage accounted for 69.455.The duration of renal damage occurred between 11 and 20 years (30.77%), cardiovascular damage (52.75%) and cerebrovascular damage (29.67%). Hyperlipidemia was the most common risk factor, accounting for 51.65%. 83 cases (91.21%) were treated with antihypertensive drugs, 8 cases (8.79%) were not treated with antihypertensive drugs, and the overall blood pressure reached the standard rate of 63.74%. 56 cases (67.47%) were treated with antihypertensive drugs and 27 cases (32.53%) were not. Most of them were treated with more than two kinds of antihypertensive drugs. The frequency of use of antihypertensive drugs was mainly CCB, followed by ARB. 4. The majority of patients with hypertension and kidney injury were physical deficiency of TCM (40.66%), the single biased constitution was yang deficiency, and qi deficiency was the majority. Among them, there were two kinds of constitution and clamp, and it was preliminarily determined that there was no significant correlation between sex and constitution distribution in patients with hypertensive renal damage. Conclusion: the elderly are the main patients with hypertensive renal damage, male is more than female, so we should pay more attention to the education of elderly patients with hypertensive renal damage. The duration of renal damage in hypertension is 11-20 years, which is not the same as that of "renal damage after 5 to 10 years' duration of hypertension". It is associated with the occult onset of the disease and the absence of specific clinical symptoms, resulting in delayed visits to patients. Most patients have been associated with multiple other target organ damage, sugar, lipid metabolism disorder. In treatment, antihypertensive drugs, either single or multi-drug combination, are mostly CCB. The traditional Chinese medicine constitution characteristic of hypertensive kidney damage patient is mainly deficiency, and also exists and clamped constitution. Hypertensive kidney damage is one or more physique involved in the development.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R544.1

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