高血压病的中医证型与睡眠紊乱及其相关危险因素分析

作者	单位
李应东杨晓瑜刘凯等	730020 甘肃中医学院附属医院（李应东、刘凯、赵信科）；730000 甘肃中医学院（李应东、杨晓瑜、刘凯）

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中文摘要:

目的探讨高血压病的中医证型、危险因素及睡眠质量的关系，以期对高血压病患者的睡眠质量改善有所助益。方法选取本院心内科门诊的高血压病患者428 例，运用匹兹堡睡眠质量指数(PSQI)量表进行评定，按其是否合并睡眠质量紊乱分为两组。同时重点询问病史(家族史、冠心病史、糖尿病史和脑卒中史)；测定身高(H)、体重(W)；检测空腹血糖(FPG)、餐后2 h 血糖(2hPBG)，总胆固醇(CHOL)、三酰甘油 (TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)，尿酸(UA)，并进行血压的测定；计算体重(BMI)。结果 ①高血压合并睡眠质量紊乱组中医证型以阴虚阳亢证多见，其次为痰湿壅盛、肝火亢盛、阴阳两虚。②高血压合并睡眠质量紊乱组（A 组）各指标相比较，A 组的家族史、冠心病史、糖尿病史及收缩压明显高于高血压病不合并睡眠质量紊乱组(B 组)P＜0.05；B 组的BMI、TC、TG、FPG、2hPBG、 HDL、LDL、UA 与A 组相比无显著性差异(P＞0.05)。③通过非条件Logistic 回归分析，收缩压是睡眠紊乱发生的主要危险因素。结论 ①高血压合并睡眠质量紊乱组患者中医证型以虚实夹杂为主，以阴虚阳亢证多见。②高血压家族史、冠心病史、糖尿病史、高收缩压是高血压病合并睡眠质量紊乱的主要危险因素。

英文摘要:

Objective Study on relationship among syndromes of traditional Chinese medicine, risk factors and sleep quality of hypertension, which aims topromote the sleep qulity of hypertension. Methods Selecting 428people in essential hypertensive patients of cardiovascular internal medicine clinic,using the Pittsburgh sleep quality index(PSQI) scale to assess, and dividing into two groups based on the complication of sleep quality disturbance. At meanwhile, focusing on asking history (family history, coronary heart disease history, diabetes history and brain stroke history); determinating height(h)and weight(w); detecting fasting blood glucose (FPG), meal hou 2H blood glucose(2hPBG), lipid four items: total cholesterol(CHOL), glycerol three ester (TG), high density fat protein (HDL), low density fat protein (LDL), and uric acid (UA), and determinating blood pressure. Calculated weight (BMI)=W(kg)/[H(m)]2. Results ①The common TCM syndrome of the group of hypertension with sleep quality disturbance is Yang excess due to Yin deficiency, which followed by the syndromes of phlegm damp excess, liver-fire ascending, and deficiency of both yin and Yang.②All index phase comparison of Hypertension with sleep quality disturbance group (A group), such as family history, coronary heart disease history, diabetes history, and brain stroke history and the contraction pressure are all higher than hypertension disease without sleep quality disturbance Group (B group), P<0.05. There is no significant differences(P>0.05)of BMI, TC,TG, FPG, 2hPBG, HDL, LDL, and UA between Agroup and B group. ③Trough non-conditional Logistic regression analysis, systolic blood pressure is the main risk factor for sleep disorders. Conclusion ① TCM syndromes of hypertension patients with sleep quality disturbance group dominated by intermingled deficiency and excess, especially of Yin deficiency and Yang hyperactivity syndrome. ②History of family history of hypertension, coronary heart disease history, diabetes history, high systolic blood pressure are the major risk factors for hypertension with sleep quality disturbance.

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