基于中医体质辨识治疗社区高血压的临床研究
1. 昆明市官渡区妇幼健康服务中心, 云南昆明 650200
2. 云南中医药大学, 第一临床学院, 云南昆明 650500
| 摘 要： | 目的：观察根据中医体质辨识结果以加味钩藤饮化裁治疗高血压的临床疗效。方法：对辖区高血压慢病管理患者82例，以随机的方式分成对照组41例，治疗组41例，2组患者均给予生活方式干预指导，对照组维持原降压药治疗；治疗组在原降压药基础上，根据中医体质辨识结果应用中医处方加味钩藤饮化裁治疗，比较两组的血压治疗及中医症候积分效果。结果：两组患者经过治疗，血压均下降，对照组的血压疗效总有效率为75.6%，治疗组的血压疗效总有效率为92.6%，治疗组的降压效果优于对照组，差异有统计学意义（p<0.05）。两组的中医证候疗效比较，治疗后两组患者的中医证候均较前改善，且治疗组总有效率为95.1%高于对照组的87.8%，差异有统计学意义（p<0.05）。结论：在继服降压药基础上，结合中医体质辨识指导选用中医处方治疗，可以平稳控制其血压，改善临床症状、提高生活质量，简化中医辨证难度，相对统一标准，便于基层医务人员掌握并使用，为探索出适合社区高血压的中西医结合防治新模式提供参考。 |
| 关 键 词： | 社区高血压; 中医体质辨识; 防治模式; 临床研究 |
| DOI： | 10.57237/j.cmrd.2023.03.002 |
View:
Downloads:
收稿日期: 2023-06-19
接受日期: 2023-08-14
在线出版日期: 2023-08-29
Clinical Research on the Treatment of Hypertension in the Community Based on TCM Physique Identification
1. Maternal and Child Health Service Center of Guandu District, Kunming 650200, China
2. The First Clinical College, Yunnan University of Traditional Chinese Medicine, Kunming 650500, China
| Abstract: | Objective: To observe the clinical efficacy of flavored hook vine drinking in the treatment of hypertension according to the results of traditional Chinese medicine physique identification. Methods: Eighty-two patients with hypertension and chronic disease management in the jurisdiction were randomly divided into 41 cases in the control group and 41 cases in the treatment group, and lifestyle intervention guidance was given to the patients in both groups, and the control group maintained the original antihypertensive drug treatment. On the basis of the original antihypertensive drugs, the treatment group was treated with Chinese blood pressure treatment and TCM symptoms based on the results of TCM physique identification, and compared the blood pressure treatment and TCM symptom score effects of the two groups. Result: After treatment, both groups of patients showed a decrease in blood pressure. The total effective rate of blood pressure in the control group was 75.6%, while the total effective rate of blood pressure in the treatment group was 92.6%. The antihypertensive effect of the treatment group was better than that of the control group, with a statistically significant difference (p<0.05). The comparison of traditional Chinese medicine syndrome efficacy between the two groups showed that the traditional Chinese medicine syndrome of both groups of patients improved after treatment, and the total effective rate of the treatment group was 95.1% higher than that of the control group (87.8%), with a statistically significant difference (p<0.05). Conclusion: On the basis of taking antihypertensive drugs, combined with the guidance of traditional Chinese medicine constitution identification, selecting traditional Chinese medicine prescriptions for treatment can steadily control blood pressure, improve clinical symptoms, improve quality of life, simplify the difficulty of traditional Chinese medicine syndrome differentiation, relatively unify standards, and facilitate grassroots medical personnel to master and use. This provides reference for exploring a new model of integrated traditional Chinese and Western medicine prevention and treatment suitable for community hypertension. |
| Keywords: | Community Hypertension; TCM Physique Identification; Prevention and Treatment Model; Clinical Research |
基金
| 1. | 云南省万人计划名医专项人才项目 (2019-35) |
| 2. | 云南省基层名中医工作站建设项目 (2021-01) |
| 3. | 昆明市卫生科研课题立项项目 (2022-14-01-023) |
参考文献
| [1] | 王增武, 杨瑛, 王文, 等. 中国高血压流行新特征-中国高血压调查的亮点和启示 [J]. 中国循环杂志, 2018, 33 (10): 937-939. |
| [2] | Heidenreich P, Trogdon J, Khavjou O, et al. Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation. 2011; 123: 933-44. |
| [3] | 魏新伟. 不同降压药物联合治疗对老年高血压合并慢性心衰患者血压变异性及心衰疗效的影响 [J]. 中国医学工程, 2021, (05): 49-54. |
| [4] | 胡大一. 高血压基层诊疗指南 (2019年) [J]. 中华全科医师杂志, 2019 (04): 301-313. |
| [5] | 中药新药临床研究指导原则 [M]. 北京: 中国医药科技出版社, 2002: 68-73. |
| [6] | 高血压中医诊疗专家共识 [J]. 中国实验方剂学杂志, 2019, 25 (15): 217-221. |
| [7] | 原国家卫生计生委. 国家基本公共卫生服务规范 (第三版) [Z]. 2017-2-28. |
| [8] | 田昕彤; 周巍; 杨继; 马腾; 赵英强. 钩藤及其配伍制剂治疗高血压的研究进展 [J]. 中草药, 2023, 54 (13): 4395-4403. |
| [9] | 索建兰; 丘建荣. 抗高血压中药的研究进展 [J]. 中国民族民间医药, 2010, 19 (02): 21-27. |
| [10] | 康鑫; 金华. 杜仲的药理学研究进展及前景展望 [J]. 内蒙古中医药, 2015 (12): 99-100. |
| [11] | 王立; 薛冰; 梁爽等. 川牛膝药理作用的研究进展 [D]. 2017. |
| [12] | 杨军林. 天麻钩藤饮治疗高血压眩晕的临床效果 [J]. 内蒙古中医药, 2022 (06): 18-19. |
| [13] | 张玉昆; 冯月男; 卞敬琦等. 丹参饮对高脂血症模型大鼠降脂机制的研究 [J]. 上海中医药杂志, 2021, 55 (11): 80-84. |
| [14] | 吕燕宇, 张兵, 王惠君, 等. 1991—2015年中国9省成年农民高血压患病率, 知晓率和治疗率的变化趋势及人口经济学差异 [J]. 中华流行病学杂志. 2020. 41 (4): 498-503. |
| [15] | 祁素芬. 中国成人高血压亚型的患病率变化趋势及发病率的研究 [C]. 河北医科大学, 2016. |
