摘要
【目的】探究慢性肾脏病合并高血压患者中医证型与晨峰现象及血压下降率的相关性。【方法】采用回顾性分析方法,选取2019年8月至2021年5月在广州中医药大学第一附属医院住院治疗的慢性肾脏病(CKD)3-5期合并高血压患者130例,根据中医证型分为脾肾气虚组67例和脾肾阳虚组63例。比较2组患者的24 h动态血压结果及相关辅助检查指标,分析2组患者的夜间血压下降率、杓型血压发生率(根据夜间血压下降率是否在10%~20%分为杓型和非杓型)、血压晨峰水平以及同型半胱氨酸(Hcy)和血脂指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)]之间的差异。【结果】(1)血压方面:在CKD 3-5期合并高血压的住院患者中,脾肾阳虚组患者的夜间收缩压下降率和夜间舒张压下降率均较脾肾气虚组大,差异均有统计学意义(P<0.01);而2组患者的血压晨峰水平比较,差异无统计学意义(P>0.05)。(2)血脂水平方面:脾肾阳虚组患者的TC及LDL-C水平均较脾肾气虚组高,差异均有统计学意义(P<0.05或P<0.01);而2组患者的TG及HDL-C水平比较,差异均无统计学意义(P>0.05)。(3)Hcy水平方面:脾肾阳虚组患者的Hcy水平较脾肾气虚组高,差异有统计学意义(P<0.05)。【结论】慢性肾脏病合并高血压脾肾阳虚组患者的夜间血压下降率更大,且具有更高的TC、LDL-C、Hcy水平。
Objective To investigate the correlation of traditional Chinese medicine(TCM)syndrome types with morning blood pressure surge(MBPS)and blood pressure decrease rate(BPDR)in the patients with chronic kidney disease(CKD)complicated with hypertension.Methods A retrospective analysis was carried out in the 130 CKD patients at stage 3-5(CKD3-5)complicated with hypertension who were hospitalized in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from August 2019 to May 2021.According to the TCM syndrome types,the patients were divided into spleen and kidney qi deficiency group(67 cases)and spleenkidney yang deficiency group(63 cases).The comparison of 24-hour ambulatory blood pressure results and related accessory examination indicators was performed between the two groups.Meanwhile,we explored the differences in nighttime blood pressure drop rate,the incidence of dipper type blood pressure(the classification of dipper type and non-dipper type according to the nighttime blood pressure drop rate at 10%~20%or less),MBPS level,homocysteine(Hcy)and blood lipid indexes of total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C).Results(1)Blood pressure:among the hospitalized CKD3-5 patients complicated with hypertension,the decrease rate of nighttime systolic blood pressure and nighttime diastolic blood pressure in spleen and kidney yang deficiency group was higher than that in spleen and kidney qi deficiency group,and the difference was statistically significant(P<0.01).There was no significant difference in the MBPS level between the two groups(P>0.05).(2)Blood lipid level:TC and LDL-C levels in spleen and kidney yang deficiency group were higher than those in spleen and kidney qi deficiency group,and the difference was statistically significant(P<0.05 or P<0.01).However,there were no statistical significant differences in TG and HDL-C levels between the two groups(P>0.05).(3)Hcy level:the Hcy level in spleen and kidney yang deficiency group was higher than that in spleen and kidney qi deficiency group,and the difference was statistically significant(P<0.05).Conclusion CKD patients complicated with hypertension differentiated as spleen-kidney yang deficiency have higher nighttime blood pressure decrease rate and higher TC,LDL-C and Hcy levels.
作者
彭桢明
谢慧文
PENG Zhen-Ming;XIE Hui-Wen(The First Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2022年第4期741-746,共6页
Journal of Guangzhou University of Traditional Chinese Medicine
关键词
慢性肾脏病
高血压
血压夜间下降率
同型半胱氨酸
血脂
中医证型
脾肾气虚证
脾肾阳虚证
chronic kidney disease
hypertension
nighttime blood pressure decrease rate
homocysteine(Hcy)
blood lipids
traditional Chinese medicine(TCM)syndrome
spleen and kidney qi deficiency syndrome
spleen and kidney yang deficiency syndrome
作者简介
彭桢明(1997-),男,硕士研究生,E-mail:1162405246@qq.com;通讯作者:谢慧文(1967-),女,副主任医师,硕士研究生导师,E-mail:hwgongz@163.com。
