Analysis of Clinical Characteristics and Traditional Chinese Medicine Prescription Regulirities of Refractory Hypertension Based on Real World
Objective:To explore the clinical characteristics that distinguish refractory hypertension from non-refractory hypertension,and to explore the prescription regularities of traditional Chinese medicine(TCM)treatment for refractory hypertension,so as to provide reference for effective prevention and treatment of refractory hypertension.Methods:A total of 520 patients with refractory hypertension(refractory hypertension group)and 550 patients with non-refractory hypertension(non-refractory hypertension group)who were hospitalized in Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan Hospital of Traditional Chinese Medicine,and the Fifth People's Hospital of Jinan from January 2010 to January 2024 were included.The general data,comorbidities,laboratory indicators and other clinical data of the two groups were compared to study the differences in clinical characteristics between refractory hypertension and non-refractory hypertension,and the risk factors or protective factors for refractory hypertension were explored by Logistic regression analysis.The TCM prescriptions for patients with refractory hypertension were collected from the electronic medical system of the hospital,and Traditional Chinese Medicine Inheritance Assistance System was used to analyze the regularities of TCM prescriptions,such as the Chinese medicinal frequency,properties,channel tropism and common medicinal combinations.Results:Compared with the non-refractory hypertension group,the refractory hypertension group had a longer history of hypertension(P＜0.05),a higher proportion of patients with coronary heart disease and cerebral infarction(P＜0.05),lower blood potassium level(P＜0.05),and higher levels of fasting blood glucose(FBG)and free tetraiodothyronine(FT4)(P＜0.05).Elevated levels of FBG and FT4 were risk factors for refractory hypertension,and potassium was a protective factor for refractory hypertension.The analysis of TCM prescriptions showed that the most frequently used Chinese medicinlas included Chuanxiong(Chuanxiong Rhizoma),Tianma(Gastrodiae Rhizoma),Baizhu(Atractylodis Macrocephalae Rhizoma),Fuling(Poria),and Gouteng(Uncariae Ramulus Cum Uncis),etc.Among the"four properties"of Chinese medicinals,the frequency of cold was the highest.Among the"five flavors"of Chinese medicinals,the frequency of sweet was the highest.Among the channel tropism of Chinese medicinals,the frequency of liver channel was the highest.The most frequently used medicinal combinations included Chuanxiong-Tianma,Gouteng-Tianma,Chuanxiong-Danggui(Angelicae Sinensis Radix),Chuanxiong-Fuling,Baizhu-Fuling.Conclusions:Compared with the treatment of non-refractory hypertension,the treatment of refractory hypertension should pay more attention to the changes of blood potassium,FBG and FT4 levels,and take active intervention measures.At present,the clinical treatment of refractory hypertension with TCM mainly adopts the Chinese medicinals with functions of activating blood circulation and removing blood stasis,calming the liver and relieving wind,and strengthening the spleen and relieving dampness.
refractory hypertensionclinical characteristicsrisk factorsprescrition regularitiesreal world
万方数据
维普
