女性高血压患者中医证候分类及与临床理化指标规律性研究

发布时间：2018-04-16 23:40

  本文选题：女性原发性高血压 + 中医证型　； 参考：《山东中医药大学》2016年硕士论文

【摘要】：目的:研究女性高血压患者中医证候分类及与临床理化指标的规律,为临床辨治女性高血压提供依据。方法:采用改良德尔菲法获取女性高血压中医证候分类专家意见。调查2013年1月-2015年11月间的357例女性高血压患者,获取一般资料、中医诊断、血浆同型半胱氨酸、肾素-血管紧张素-醛固酮系统相关肾上腺皮质类激素水平等检查资料。对收集到的数据进行统计学分析,得出结论。结果:女性高血压的常见证型有阴虚阳亢证、痰瘀互结证、肝火上炎证、肝气郁结证、冲任不足证。357例患者年龄平均65.6岁,病程平均12.04年,血压以Ⅱ、Ⅲ级居多。344例患者Hcy平均为14.287μmol/L。288例患者的血浆同型半胱氨酸≥10μmol/L,占83.72%。痰热内闭证血浆同型半胱氨酸最高,且与其他证候比较有统计学差异。133例患者肾素活性平均为2.85 ng/ml/hr,血管紧张素Ⅰ(37℃)平均为5.28ng/ml,血管紧张素Ⅰ(4℃)平均为1.26ng/ml。38例患者肾素定量平均为13.09 pg/ml,血管紧张素Ⅱ平均为150.75 pg/ml。171例患者醛固酮定量平均为205.123pg/ml。中医证候间肾素-血管紧张素-醛固酮系统无统计学差异。血浆同型半胱氨酸与肾素-血管紧张素-醛固酮系统无明显直线相关性。结论:1.女性高血压以阴虚阳亢证、痰瘀互结证、肝火上炎证、肝气郁结证、冲任不足证5种证型为常见证型。2.女性高血压患者中H型高血压所占比例居多。痰热内闭证血浆同型半胱氨酸水平最高。血浆同型半胱氨酸水平升高与“痰”、“瘀”、“虚”3大病因有关。3.女性高血压肾素-血管紧张素-醛固酮系统大部分处于正常水平,在各中医证候分型间无明显差异。4.血浆同型半胱氨酸与肾素-血管紧张素-醛固酮系统无明显直线相关性。
[Abstract]:Objective: to study the classification of TCM syndromes and clinical physical and chemical indexes in female patients with hypertension, and to provide evidence for clinical diagnosis and treatment of female hypertension.Methods: the modified Delphi method was used to obtain the expert opinion of TCM syndrome classification of female hypertension.357 female patients with hypertension from January 2013 to November 2015 were investigated. General data, diagnosis of traditional Chinese medicine, plasma homocysteine, renin-angiotensin-aldosterone system related adrenocortical hormone levels were obtained.Statistical analysis of the collected data, draw a conclusion.Results: the common syndromes of female hypertension were yin deficiency and yang hyperactivity syndrome, phlegm and blood stasis syndromes, liver fire inflammation syndrome, liver qi stagnation syndrome. The average age of 357 women with insufficient blood pressure was 65.6 years, the average course of disease was 12.04 years, and the blood pressure was 鈪，

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