神经源性直立性低血压合并卧位高血压中医证候要素特征研究

王倩; 张春燕; 陈玉静; 王宏; 孙亚男; 王建东; 黄小波

doi:10.16025/j.1674-1307.2022.08.021

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神经源性直立性低血压合并卧位高血压中医证候要素特征研究

临证纵横 | 更新时间：2023-02-15

- 神经源性直立性低血压合并卧位高血压中医证候要素特征研究
- Study on TCM syndrome elements characteristics of neurogenic orthostatic hypotension combined with supine hypertension
- 北京中医药 2022年41卷第8期页码：903-906
- 作者机构：
  
  1.首都医科大学宣武医院中医科，北京 100053
- 作者简介：
  
  王倩，女，39岁，博士，主治医师。研究方向：中西医结合治疗神经系统疾病及老年病。
  黄小波，E-mail： huangxiaobo@xwh.ccmu.edu.cn
- 基金信息：
  
  国家自然科学基金资助项目(81574036);北京市自然科学基金资助项目(7172094);北京市中医药科技发展资金资助项目(JJ-2020-66)
- DOI：10.16025/j.1674-1307.2022.08.021
  中图分类号：
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王倩，张春燕，陈玉静，等.神经源性直立性低血压合并卧位高血压中医证候要素特征研究［J］.北京中医药，2022，41（8）：903-906.

WANG Qian,ZHANG Chun-yan,CHEN Yu-jing,et al.Study on TCM syndrome elements characteristics of neurogenic orthostatic hypotension combined with supine hypertension[J]. Beijing Journal of Traditional Chinese Medicine,2022,41(08):903-906.
王倩，张春燕，陈玉静，等.神经源性直立性低血压合并卧位高血压中医证候要素特征研究［J］.北京中医药，2022，41（8）：903-906. DOI： 10.16025/j.1674-1307.2022.08.021.

WANG Qian,ZHANG Chun-yan,CHEN Yu-jing,et al.Study on TCM syndrome elements characteristics of neurogenic orthostatic hypotension combined with supine hypertension[J]. Beijing Journal of Traditional Chinese Medicine,2022,41(08):903-906. DOI： 10.16025/j.1674-1307.2022.08.021.

摘要

目的,2,探讨神经源性直立性低血压（nOH）合并卧位高血压（SH）患者的中医证候要素特征。,方法,2,选择nOH患者160例，根据是否合并SH分为nOH组82例，nOH+SH组78例。采用中医证候要素评分表对2组患者进行评分比较，并就各证候要素对伴发SH的危险度进行分析。,结果,2,证候要素分布方面，2组病位要素均为脑、脾、肾、肝，组间差异均无统计学意义（,P,>,0.05）；病性要素中，2组出现频率均较高的证素为气虚、髓减、肝风、痰浊证，nOH+SH组痰浊证、瘀血证所占比例均高于nOH组（,P,<,0.05），并以瘀血证更为显著（,P,<,0.05）。证候要素积分方面，nOH+SH组痰浊证、瘀血证、肝风证评分均高于nOH组（,P,<,0.05），并以痰浊证、瘀血证更为显著（,P,<,0.01）。Logistic回归分析显示，证候要素髓减证、痰浊证、瘀血证与SH发生存在相关性（,P,<,0.05），其,OR,值分别为0.037、8.504、12.721。,结论,2,nOH合并SH患者病位要素以脑为主，并与脾、肾、肝密切相关；病性要素以气虚证、髓减证、肝风证、痰浊证、瘀血证为主；痰浊证、瘀血证可能是nOH患者伴发SH的危险因素。

Abstract

Objective,2,To explore TCM syndrome elements characteristics in patients with neurogenic orthostatic hypotension （nOH） combined with supine hypertension （SH）.,Methods,2,160 patients with nOH were enrolled， and were divided into nOH group （82 cases） and nOH+SH group （78 cases） according to whether they were complicated with SH or not. The two groups of patients were scored by TCM syndrome element scoring table to make comparison，and the risks of each syndrome element to SH was analyzed.,Results,2,In terms of the distribution of syndrome elements，the disease location elements of the two groups were brain，spleen，kidney and liver，and there was no significant difference between the two groups （,P,>,0.05）. Among the disease nature，the syndrome elements with higher frequency were qi deficiency，myelopathy，liver wind and phlegm turbidity syndrome in both two groups. The proportion of phlegm turbidity syndrome and blood stasis syndrome in nOH+SH group was higher than that in nOH group （,P,<,0.05）， and blood stasis syndrome was more significant（,P,<,0.05）. Syndrome factor integral，the scores of phlegm turbid syndrome， blood stasis syndrome， liver wind syndrome scores in nOH+SH group were higher than those in nOH group（,P,<,0.05）， and phlegm turbid syndrome， blood stasis syndrome was more significant（,P,<,0.01）. Logistic regression analysis showed that the syndrome elements of myelopathy syndrome，phlegm turbid syndrome，blood stasis syndrome and the occurrence of SH were related （,P,<,0.05），the ,OR, values were 0.037，8.504 and 12.721 respectively.,Conclusion,2,Brain is the main location element in patients with nOH combined with SH， and but the spleen，kidney and liver are also involved. The main disease elements are qi deficiency syndrome，marrow reduction syndrome，liver wind syndrome，phlegm turbidity syndrome and blood stasis syndrome. Phlegm turbidity syndrome and blood stasis syndrome may be the risk factors of SH in nOH patients.

关键词

神经源性直立性低血压卧位高血压中医证候要素

Keywords

Neurogenic orthostatic hypotensionsupine hypertensionTCM syndrome elements

references

LOW PA,REICH SG,JANKOVIC J,et al.Natural history of multiple system atrophy in the USA:a prospective cohort study[J].Lancet neurol,2015,14(7):710-719.

赵然,田田,籍炀飞,等.189例帕金森病直立性低血压发生率及相关危险因素临床分析[J].中风与神经疾病杂志,2017,34(3):242-246.

FANCIULLI A,GOBEL G,NDAYISABA JP,et al.Supine hypertension in Parkinson's disease and multiple system atrophy[J].Clin Auton Res,2016,26(2):97-105.

CANNOM DS.Management of coexistent neurogenic orthostatichypotension and supine hypertension[J].J Clin Hypertens,2019,21(11):1732-1734.

FREEMAN R,WIELING W,AXELROD FB,et al.Consensus statement on the definition of orthostatic hypotension,neurally mediated syncope and the postural tachycardia syndrome[J].Auton Neurosci,2011,161(1-2):46-48.

GIBBONS CH,SCHMIDT P,BIAGGIONI I.The recommendations of a consensus panel for the screening, diagnosis,and treatment of neurogenic orthostatic hypotension and associated supine hypertension[J].J Neurol,2017,264(8):1567-1582.

FANCIULLI A,JORDAN J,BIGGIONI I,et al.Consensus statement on the defnition of neurogenic supine hypertension in cardiovascular autonomic failure by the American Autonomic Society (AAS) and the European Federation of Autonomic Societies (EFAS)[J].Clinical Autonomic Research,2018,28(4):355-362.

陈家旭.中医诊断学[M].北京：中国中医药出版社,2015:152-178.

周仲英.中医内科学[M].北京：中国中医药出版社,2019:186-195,312-319,448-459.

国家技术监督局.中医临床诊疗术语·证候部分：GB/T 16751.2-1997[S].北京：中国标准出版社,1997:1-16.

朱文峰.证素辨证学[M].北京：人民卫生出版社,2008:200-226.

郑筱萸.中药新药临床研究指导原则[M].北京：中国医药科技出版社,2002:378-383.

徐迪华.中医量化诊断[M].南京：江苏科学技术出版社,1997:42-88.

PALMA JA,GMOEZ-ESTEBAN JC,NORCLIFFE-KAUFMANN L,et al.Orthostatic hypotension in Parkinson disease: how much you fall or how low you go?[J].Mov Disord,2015,30(5):639-645.

李爽姿，王勤明.《诸病源候论》之“候”的探析[J].北京中医药,2019,38(7):674-675.

静馨，郭伟聪，陈泽煌.四味回阳饮加味治疗气厥型神经源性体位性低血压30例[J].福建中医药,2017,48(6):10-11,23.

王粟实，陈路，任珊,等.温肾健脑经验方治疗多系统萎缩的临床疗效观察[J].中华中医药杂志,2017,32(5):2005-2010.

张沛然.益髄汤治疗神经源性直立性低血压脾肾亏虚证疗效观察及其对多系统萎缩的生存影响[D].北京:北京中医药大学,2018:37-57.

申达甫，何志伟.升阳举陷汤治疗帕金森病伴体位性低血压的疗效及对心率变异性与认知功能的影响[J]. 现代中西医结合杂志,2021,30(21):2332-2336.

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