目的 探讨青年原发性高血压病中医证型与相关因素间的关系。方法 采用横断面研究设计，收集2017年12月-2021年12月中国中医科学院西苑医院心血管科住院患者中符合纳排标准的病例资料，通过Logistic回归分析方法探讨相关关系。结果 研究共纳入202例青年高血压病住院病例，中医证型分布依次为痰瘀互结证(51。98％)、阴虚阳亢证(24。75％)、气血两虚证(15。84％)、肾阳亏虚证(7。43％)。Logistic回归分析显示，脑梗死病史、高血压病分期、低密度脂蛋白胆固醇(LDL-C)水平、24 h平均收缩压(24 h ASBP)、24 h平均脉搏(24 h AP)、日间平均脉搏(dAP)、夜间平均脉搏(nAP)对气血两虚证有影响(P＜0。05);高血压病分期、脂蛋白B(Apo B)水平、最高收缩压(max-SBP)对肾阳亏虚证有影响(P＜0。05);脂肪肝病史、高密度脂蛋白胆固醇(HDL-C)降低、LDL-C升高、糖化血红蛋白(HbA1c)升高、估算肾小球滤过率(eGFR)降低、24hAP、dAP对痰瘀互结证有影响(P＜0。05);年龄、动脉粥样硬化、LDL-C降低、Apo B降低、HbA1c升高、夜间平均舒张压(nADBP)、舒张压时间升高百分比(PTE％-DBP)对阴虚阳亢证有影响(P＜0。05)。结论 青年高血压病住院患者中痰瘀互结证最多，中医证型与年龄、既往史、高血压病分期、相关血清学指标及动态血压指标之间存在一定的相关关系。
Analysis of Chinese Medicine Syndrome Types and Related Factors in Young Patients with Essential Hypertension
Objective To explore the relationship between Chinese medicine(CM)syndrome types and related factors in young patients with essential hypertension.Methods A cross-sectional study design was used to collect data from inpatients in the Cardiology Department of Xiyuan Hospital,China Academy of Chinese Medical Sciences,from December 2017 to December 2021.Logistic regression analysis was employed to explore the relevant relationships.Results A total of 202 young hypertensive inpatients were included in the study.The distribution of CM syndrome types were as follows:phlegm and blood stasis syndrome(51.98％),Yin deficiency and Yang hyperactivity syndrome(24.75％),Qi and blood deficiency syndrome(15.84％),Shen Yang deficiency syndrome(7.43％).Logistic regression analysis showed that the history of cerebral infarction,hypertension stage,low-density lipoprotein cholesterol(LDL-C)level,24-hour average systolic blood pressure(24 h ASBP),24-hour average pulse(24 h AP),daytime average pulse(dAP),and nighttime average pulse(nAP)had an impact on Qi and blood deficiency syndrome(P＜0.05).Hypertension stage,apolipoprotein B(Apo B)level,and maximum systolic blood pressure(max-SBP)affected Shen Yang deficiency syndrome(P＜0.05).The history of fatty liver,lower high-density lipoprotein cholesterol(HDL-C),higher LDL-C,higher glycosylated hemoglobin(HbA1c),lower estimated glomerular filtration rate(eGFR),24 h AP,and dAP affected phlegm and blood stasis syndrome(P＜0.05).Age,atherosclerosis,decreased LDL-C,decreased Apo B,increased HbA1c,nighttime average diastolic blood pressure(nADBP),and percent time elevation of diastolic blood pressure(PTE％-DBP)influenced Yin deficiency and Yang hyperactivity syndrome(P＜0.05).Conclusions Phlegm and blood stasis syndrome is the most common CM syndrome among young hypertensive inpatients.There is a significant correlation between CM syndrome types and age,medical history,hypertension stage,related serological markers,and ambulatory blood pressure indicators.
young hypertensionChinese medicine syndrome typesrelated factorsLogistic regression analysisintegrative medicine
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