血压晨峰的中医证型特点与相关危险因素的临床研究

发布时间：2018-03-30 09:15

本文选题：血压晨峰　切入点：24h动态血压监测　出处：《广州中医药大学》2016年硕士论文

【摘要】：目的：通过采集血压晨峰患者的相关数据,探讨血压晨峰患者的中医证型分布情况及其与年龄、血压级别、病程、血脂、尿微量白蛋白、颈动脉内膜中层厚度情况、血尿酸等相关危险因素的关系。方法：采纳2015年7月至2016年5月入住广东省中医院心血管科并确诊为高血压病的患者,行24h动态血压监测筛查出血压晨峰患者并完善其余各项检查,采集相关数据后利用SPSS统计软件进行分析,得出结果,探讨血压晨峰患者的中医证型分布情况及其与年龄、血压级别、病程、血脂、尿微量白蛋白、颈动脉内膜中层厚度情况、血尿酸等相关危险因素的关系。结果：(1)课题共纳入110例患者。按中医证候分组,肝火亢盛证26例,占23.6%,平均MBPS值37.54±1.58mmHg；阴虚阳亢证18例,占16.5%,平均MBPS值36.79±1.03mmHg；阴阳两虚证23例,占23.9%,平均MBPS值36.99±0.96mmHg。痰湿壅盛证43例,占39.1%,平均MBPS值38.88±2.64mmHg。经单因素方差分析比较,P0.05,差异显著。(2)按血压级别分组,高血压1级患者8例,占7.3%,平均MBPS值36.23±0.79mmHg；高血压2级患者24例,占21.8%,平均MBPS值37.34±2.27mmHg；高血压3级患者78例,占70.9%,平均MBPS值38.15±2.09mmHg,经单因素方差分析显示,P0.05,层级差异显著。(3)按年龄分组,55岁及以下血压晨峰患者18例,占16.4%,平均MBPS值37.17±1.31mmHg；56～65岁血压晨峰患者36例,占32.7%,平均MBPS值37.59±2.30mmHg；66-75岁血压晨峰患者22例,占20.0%,平均MBPS值38.16±2.93mmHg；76～85岁血压晨峰患者34例,占30.9%,平均MBPS值38.17±1.35mmHg。经方差分析比较,P0.05,无明显统计学差异。(4)按高血压病程分组,病程小于10年者61例,占55.5%,平均MBPS值37.37±1.88mmHg；病程介于10～20年者24例,占21.8%,平均MBPS值38.05±1.51mmHg；病程大于20年者25例,占22.7%,平均MBPS值 38.74±2.74mmHg。方差分析显示,P0.05,差异显著。(5)按IMT增厚情况分组,双侧IMT未增厚者20例,平均MBPS者36.96±2.34mmHg；单侧IMT增厚者17例,平均MBPS36.92±1.22mmHg；双侧IMT均增厚者64例,平均MBPS值38.40±2.12mmHg。方差分析显示,P0.05,差异显著。(6)按24h节律分组,24h节律存在者18例,平均MBPS值37.58±2.45mmHg；24h节律消失或倒置者83例,平均MBPS值37.96±2.05mmHg；经t检验,P0.05。(7)按AASI分组,AASI小于0.55者64例,平均MBPS值37.83±1.89mmHg；AASI大于等于0.55者39例,平均MBPS值37.92±2.49mmHg。经比较,P0.05。(8)按TCD血流情况分组,TCD正常者30例,平均MBPS值36.95±1.46mmHg；TCD血流异常者65例,平均MBPS值38.24±2.12mmHg。经比较,二组P0.05。(9)按尿微量白蛋白分组,尿微量白蛋白升高组19例,平均MBPS值39.48±3.02mmHg；正常组42例,平均MBPS值37.14±1.35mmHg。经比较,P0.05。(10)按血尿酸分组,尿酸正常者59例,平均MBPS值37.33±1.10mmHg；尿酸升高者36例,平均MBPS值37.43±1.25mmHg,经比较,P0.05。(11)血脂方面,TC正常者65例,平均MBPS值37.52±1.54mmHg,TC升高者36例,平均MBPS值38.084±2.86mHg,t检验显示P＜0.05.NOn-HDL-C正常者67例,平均MBPS值37.49±1.52mmHg,升高者34例,平均MBPS值38.60±2.90mmHg,t检验显示P〈0.05。其余血脂(包括TG.HDL-C、LDL-C)分别进行分组比较,经t检验,P0.05。结论：血压晨峰与病程、血压级别有关,病程愈长、血压级别愈高者,其血压晨峰值愈大；血压晨峰与血脂异常有一定关系,TC或non-HDL-C异常者,其血压晨峰值愈大；血压晨峰愈大,患者愈容易出现尿微量白蛋白增高；血压晨峰值愈大,患者TCD血流情况、IMT愈容易出现异常；痰湿壅盛证患者血压晨峰值较其余证型高。
[Abstract]:Objective: through the relevant data collection of morning blood pressure surge of patients, to explore the distribution of TCM syndromes in patients with morning blood pressure surge and blood pressure levels, age, duration, blood lipid, urinary albumin, carotid intima-media thickness, the relationship between blood uric acid and related risk factors. Methods: from July 2015 to May 2016 in Guangdong Province Traditional Chinese Medical Hospital adopted in cardiovascular department and diagnosed in patients with hypertension, 24h ambulatory blood pressure monitoring in patients with morning blood pressure peak and improve the rest of the inspection, after collecting relevant data were analyzed by SPSS statistical software, the results of the distribution of TCM syndromes in patients with morning blood pressure surge and blood pressure levels, age, duration, blood lipid, urine trace albumin, carotid intima-media thickness, the relationship between blood uric acid and related risk factors. Results: (1) study included 110 patients grouped according to TCM syndrome, Anger hyperactivity syndrome 26 cases, accounting for 23.6%, the average MBPS value of 37.54 + 1.58mmHg; Yin deficiency and yang hyperactivity syndrome 18 cases, accounting for 16.5%, the average value of MBPS 36.79 + 1.03mmHg two; deficiency of yin and Yang 23 cases, accounting for 23.9%, the average value of MBPS 36.99 + 0.96mmHg. phlegm dampness syndrome in 43 cases, accounting for 39.1%, 38.88 + 2.64mmHg. the single factor variance analysis, P0.05, significant difference between the average MBPS value. (2) groups according to the blood pressure level, grade 1 hypertension patients in 8 cases, accounting for 7.3%, the average MBPS value of 36.23 + 0.79mmHg; grade 2 hypertension patients in 24 cases, accounting for 21.8%, the average MBPS value of 37.34 + 2.27mmHg; grade 3 hypertension patients in 78 cases, accounting for 70.9%, the average MBPS value of 38.15 + 2.09mmHg, the single factor variance analysis showed that the level of P0.05, the difference was significant. (3) according to the age, under the age of 55 and the morning blood pressure surge in patients with 18 cases, accounting for 16.4%, the average MBPS value of 37.17 + 1.31mmHg; 56~65 Mbps in patients with 36 cases, accounting for 32.7%, average MBPS a value of 37.59 + 2.30mmHg; 66-75 year old blood pressure Morning peak in 22 cases, accounting for 20%, the average MBPS value of 38.16 + 2.93mmHg; 76~85 Mbps in patients with 34 cases, accounting for 30.9%, 38.17 + 1.35mmHg. by variance analysis, the average P0.05 value of MBPS, no significant difference. (4) groups according to the duration of hypertension, duration of less than 10 years in 61 cases, accounting for 55.5% MBPS, the average value of 37.37 + 1.88mmHg; duration ranged from 10~20 years in 24 cases, accounting for 21.8%, the average MBPS value of 38.05 + 1.51mmHg; the course of more than 20 years in 25 cases, accounting for 22.7%, 38.74 + 2.74mmHg. variance analysis showed that the average value of MBPS P0.05, the difference was significant. (5) grouped by IMT thickening, 20 cases of bilateral IMT thickening of MBPS, average 36.96 + 2.34mmHg; 17 cases of unilateral IMT thickening, the average MBPS36.92 + 1.22mmHg; 64 cases of bilateral IMT were thickened, 38.40 + 2.12mmHg. variance analysis showed that the average value of MBPS P0.05, the difference was significant. (6) grouped according to the 24h 24h rhythm rhythm, there were 18 cases, an average of MBPS a value of 37.58. 2.45mmHg; 83 cases of 24h rhythm disappeared or inverted, the average MBPS value of 37.96 + 2.05mmHg; by t test, P0.05. (7) group by AASI, AASI is less than 64 in 0.55 cases, the average MBPS value of 37.83 + 1.89mmHg; AASI is greater than or equal to 0.55 in 39 cases, the average MBPS value of 37.92 + 2.49mmHg. by comparison, P0.05. (8 TCD) groups according to the blood flow, 30 cases with normal TCD, the average value of MBPS 36.95 + 1.46mmHg TCD; 65 cases of abnormal blood flow, the average MBPS value of 38.24 + 2.12mmHg. by comparison, two groups of P0.05. (9) groups according to urinary albumin, 19 cases of microalbuminuria group increased, the average MBPS value of 39.48 + 3.02mmHg; normal group of 42 cases, the average MBPS value of 37.14 + 1.35mmHg. by comparison, P0.05. (10) groups according to the serum uric acid, uric acid in 59 cases of normal subjects, the average MBPS value of 37.33 + 1.10mmHg; uric acid increased in 36 cases, the average MBPS value of 37.43 + 1.25mmHg, by comparison, P0.05. (11) blood, 65 cases with normal TC. The average value of MBPS 37.52 + 1.54mmHg, T 36 cases of C increased, the average MBPS value of 38.084 + 2.86mHg, P < T test showed 67 cases of normal 0.05.NOn-HDL-C, the average MBPS value of 37.49 + 1.52mmHg, 34 cases were increased, the average MBPS value of 38.60 + 2.90mmHg, t P "0.05. test showed that the blood lipid (TG.HDL-C, LDL-C) were divided into groups by t test, P0.05. conclusion: morning blood pressure surge and the course of disease, blood pressure level, longer duration, higher blood pressure levels, the peak morning blood pressure is bigger; there is a certain relationship between morning blood pressure surge and dyslipidemia, TC or non-HDL-C are abnormal, the morning blood pressure peak morning blood pressure peak is bigger; larger, more patients prone to urinary albumin increased; morning blood pressure peak more blood flow in patients with TCD, IMT is more prone to abnormalities; phlegm dampness syndrome of morning blood pressure peak than the other syndromes.

【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

【相似文献】