摘要
目的:应用横断面调查方法,进行老年高血压常见证候患者生活质量差异比较的小样本预试验,为进一步开展人群流行病学调查研究提供依据。方法:在山东省不同经济发展水平的三个地区机关退休人群中,筛选未合并重大疾病的60～79岁高血压患者96例,通过标准问卷调查形式收集年龄、性别、职业、身高、体重、心率等基线资料和证候分级量化资料:(1)根据《中药新药临床研究指导原则》确立阴虚阳亢、阴阳两虚、肝火亢盛、痰湿壅盛等单一证候及其组合证候,作为标准证候分型,定义阴阳两虚证为虚证,肝火亢盛证、痰湿壅盛证和肝火亢盛+痰湿壅盛证为实证,阴虚阳亢及其它组合证候为虚实夹杂证。(2)以世界卫生组织生活质量量表简表(WHOQOL-BREF)为普适性量表、高血压生活质量量表(杜氏量表)简表为高血压特异性量表对患者生活质量进行测定,比较上述不同证型的生活质量评分差异。结果:(1)老年高血压的常见证候分布依次为阴阳两虚+阴虚阳亢证(41/96)、阴阳两虚证(32/96)和阴虚阳亢证(15/96);鉴于其他5个证候的样本量较小(理论频数小于5),尚不能证实上述证候构成比的临床意义。将阴阳两虚+阴虚阳亢证、阴阳两虚证和阴虚阳亢证共计88例作为有效证候样本。(2)上述三种证候分型患者的基线资料、肱动脉收缩压、舒张压和脉压的差异均无显著性(P＞0.05),具备可比性。(3)与阴阳两虚证相比,阴虚阳亢+阴阳两虚证在生理、心理二领域,生理症状、躯体症状、睡眠状况、焦虑、压抑、强迫症状六方面评分降低的差异均具有显著性(P＜0.05);与阴虚阳亢证相比,阴虚阳亢证+阴阳两虚证在生理症状、躯体症状、焦虑三方面评分降低的差异均具有显著性(P＜0.05);阴阳两虚证与阴虚阳亢证在各领域、方面评分的差异均无显著性(P＞0.05)。结论:老年高血压以虚证及虚实夹杂证型较为常见,基本证候可能阴阳两虚证,阴虚阳亢证+阴阳两虚证在生理症状、躯体症状等方面评分显著低于阴阳两虚、阴虚阳亢组,提示阴虚阳亢证+阴阳两虚证在多方面生活质量降低更明显。
Objective:A cross-sectional survey method,carry out certification and common syndrome types of TCM in elderly hypertensive patients of quality of life difference between pre-test in small samples,for further investigation and study groups provide a basis for epidemiological.Methods:In Shandong Province,the level of economic development in different regions of the three organs of the retirement population,screening is not of major diseases combined 60～79-year-old patients with 96 cases of high blood pressure,through a standard form of questionnaire survey to collect age,sex,weight,heart rate,such as baseline information and quantitative data classification Syndrome:(1)according to "Chinese medicine clinical research guiding principles" established Yin deficient positive high,Yin and Yang deficiency,Liver Kang Sheng,a single Phlegm Yong Sheng dampness and combinations Syndrome Syndrome,Syndrome as a standard sub-type,the definition of Deficiency for the deficiency of yin and yang of two,Kang Sheng irascibility card,card Phlegm Yong Sheng dampness and phlegm irascibility Kang Sheng + Phlegm Yong Sheng for empirical evidence,and other combinations Yin deficient positive high Yin deficient positive high Phlegm Phlegm Yong Sheng irascibility syndrome evidence for the actual situation inclusions.(2)Using the world health organization quality of life simple questionnaire as universal scale an hypertension syndromes questionnaire bref as specifical scale to compare the different evidence-based Center for differences in quality of life parameters.Results:(1)common in elderly hypertensive syndrome followed by the distribution of yin and yang deficiency +Yin deficient positive high Card(41/96),both yin and yang deficiency(32/96) and Yin deficient positive high Card(15/96),but in view of Other Syndromes of five smaller sample size(theoretical frequency is less than 5),yet could not confirm the above-mentioned syndromes constitute the clinical significance than that.The yin and yang deficiency +Yin deficient positive high card,yin and yang,the two Yin deficient positive high Deficiency and a total of 88 cases of certification as an effective sample Syndrome.(2)these three types of patients with syndrome of baseline data,brachial artery systolic pressure,diastolic blood pressure and pulse pressure was no significant difference (P＞0.05),comparable.(3)with deficiency of yin and yang of two compared to Yin deficient positive high and deficiency of yin and yang of two have reduced the difference significant(P＜0.05) in mental and physical field area of two and physical symptoms,somatic symptoms,morpheus condition,anxiety,depression,and obsessional-compulsive aspect of six;with Yin deficient positive high compared to Yin deficient positive high and deficiency of yin and yang of two have reduced the difference significant(P＜0.05) in physical symptoms,somatic symptoms and anxiety aspect of three;certification Yin deficient positive high and deficiency of yin and yang of two there were no significant differences(P＞0.05) in every area and aspect.Conclusion:in elderly hypertensive and the actual situation in a mixture of Deficiency Syndromes are more common,basic deficiency of yin and yang syndrome may permit the center of patients;quality of life score of Yin deficient positive high and deficiency of yin and yang of two group reduce significantly in many areas and aspects,suggesting that quality of life of Yin deficient positive high and deficiency ofyin and yang of two reduce significantly.
引文
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