高血压合并睡眠障碍中医证素与危险因素相关性研究OA

Objective To investigate the correlation between traditional Chinese medicine(TCM)syndrome elements and risk factors in patients with hypertension complicated by sleep disorders.Methods Medical records of 200 patients with hypertension and comorbid sleep disorders were retrospectively analyzed.The distribution of TCM syndrome elements was statistically summarized,and the associations between different syndrome elements and risk factors including sex,age,smoking history,diabetes mellitus,and dyslipidemia were examined.Results(1)Among the 200 patients,the distribution of location-related syndrome elements was as follows:spleen in 124 cases(62.00%),liver in 100 cases(50.00%),heart in 95 cases(47.50%),kidney in 70 cases(35.00%),and lung in 34 cases(17.00%).The distribution of nature-related syndrome elements was:qi deficiency in 123 cases(61.50%),phlegm-dampness in 100 cases(50.00%),yin deficiency in 65 cases(32.50%),yang hyperactivity in 70 cases(35.00%),blood stasis in 40 cases(20.00%),qi stagnation in 38 cases(19.00%),heat in 35 cases(17.50%),and yang deficiency in 10 cases(5.00%).(2)Statistically significant differences were observed in the distribution of qi deficiency,phlegm-dampness,yang hyperactivity,heat,qi stagnation,and blood stasis between sexes(P＜0.05 or P＜0.01 or P＜0.001),and in the distribution of qi deficiency,phlegm-dampness,yang hyperactivity,and yin deficiency among different age groups(P＜0.01 or P＜0.001).(3)Logistic regression analysis of the correlation between TCM syndrome elements and risk factors showed:In patients with hypertension and sleep disorders,sex[OR=0.203,95%CI(0.097-0.425)]was negatively correlated with qi deficiency,while age[OR=1.069,95%CI(1.033-1.106)]and renal insufficiency[OR=29.056,95%CI(3.722-226.804)]were positively correlated with qi deficiency.Sex[OR=0.151,95%CI(0.063-0.363)]was negatively correlated with phlegm-dampness,whereas dyslipidemia[OR=18.997,95%CI(7.841-46.028)]and cerebral infarction[OR=16.215,95%CI(5.420-48.516)]were positively correlated with phlegm-dampness.Sex[OR=3.202,95%CI(1.591-6.443)]and smoking history[OR=9.094,95%CI(4.184-19.770)]were positively correlated with yang hyperactivity.Sex[OR=5.003,95%CI(2.212-11.313)],diabetes mellitus[OR=12.396,95%CI(5.493-27.975)],and cerebral infarction[OR=2.853,95%CI(1.217-6.684)]were positively correlated with yin deficiency.Coronary heart disease[OR=24.982,95%CI(6.623-94.239)]and cerebral infarction[OR=46.025,95%CI(11.209-188.984)]were positively correlated with blood stasis.All the above variables showed statistically significant differences(P＜0.05 or P＜0.01 or P＜0.001).Conclusion In patients with hypertension and sleep disorders,the disease locations are primarily the spleen,liver,and heart,with close associations with the kidney and lung.The overall pathogenesis is characterized by deficiency in the origin and excess in the superficiality,with qi deficiency and yin deficiency as the root cause,and phlegm-dampness and yang hyperactivity as the branch.Among these patients,females are more likely to present with qi deficiency and phlegm-dampness syndrome,while males are more likely to present with yang hyperactivity and yin deficiency syndrome.Advancing age is associated with the occurrence of qi deficiency.Smokers frequently exhibit yang hyperactivity,whereas patients with diabetes mellitus tend to present with yin deficiency.Patients with dyslipidemia are more prone to phlegm-dampness,those with coronary heart disease are more likely to have blood stasis,and those with cerebral infarction are more likely to exhibit phlegm-dampness,yin deficiency,and blood stasis.Qi deficiency is common in patients with renal insufficiency.