心脑合病血压与中医证型及中医四诊症状间的关系

目的：以心脑合病患者为研究对象，探究其血压与中医四诊症状及中医证型间的关系。方法：临床流行病学调查采用横断面调查法。采用SPSS17．0统计分析软件包对资料进行统计分析。血压与中医证型间关系研究采用频数（构成比）及卡方检验进行统计分析。血压与四诊症状间关系研究采用Spearman相关分析、Logistic回归分析、判别分析及ROC曲线法。结果：①心脑舍病患者既往史中高血压排在首位，占73．73％。②高血压在心脑合病风痰阻络证、痰瘀阻络证、气阴两虚证、痰浊中阻证、肝阳上亢证、痰瘀互结证及风痰阻络气阴两虚证中的分布高于气虚血瘀证。③建立了心脑合病中高血压与四诊症状的判别模型：高血压=0．926％肥胖＋0．879言謇＋2．055＊腹部凹陷＋0．6478舌苔稍后＋0．829＊燥苔-1．388＊半身不遂-1．739＊肌肤甲错-0．677＊头晕耳呜-0．898＊涩脉-6．048＊舌态吐弄＋0．296。其ROC曲线下面积为0．720。结论：①高血压患者在心脑合病中医证型分布差异具有统计学意义。②高血压在心脑合病中医证型中分布排在前四位的是：痰瘀阻络证（82．76％）、风痰阻络证（82．43％）、痰浊中阻证（82．35％）及肝阳上亢证（82．35％）。③本研究挖掘出肥胖、言謇、胸闷程度、燥苔、舌苔滑腻、舌苔黏腻、半身不遂、数脉、涩脉、舌态吐弄等中医四诊症状与心脑舍病患者的血压具有相关性，并可建立相应的判别模型。

Relationship between Blood Pressure with Four Diagnostic Symptoms and TCM Syndromes in Angina Pectoris Combined with Cerebral Infarction

Objective： In this paper, patients with angina pectoris combined with cerebral infarction were studied to explore the relationship between blood pressure with four diagnostic symptoms and TCM syndrome type. Methods ： A cross - sectional survey of clinical epidemiology survey was carried on. SPSS 17.0 was used for statistical analysis of the data. Frequency analysis （constituent ratio） and the chi -square test were used to analyze the relationship between blood pres- sure with four diagnostic symptoms and TCM syndromes. While analyzing the relationship between blood pressure with four diagnostic symptoms and TCM symptoms, we chose Spearman Correlation Analysis and logistic regression analysis, discriminant analysis and ROC curve. Results： ① Hypertension ranked first in previous history of patients with angina pectoris combined with cerebral infarction, accounting for 73.73 %. ②The distribution of patients with hypertension in qi - deficiency and blood - stasis syndrome （QBDS） was lower than that in syndromes as follows, wind phlegm syndrome, phlegm and blood stasis syndrome, qi and yin deficiency syndrome, phlegm retention syndrome, hyperactivity of liver yang, phlegm and blood stasis, and wind phlegm with qi and yin deficiency. ③We built discriminant model of the dis- ease in hypertension with four diagnostic symptoms ： Hypertension = 0. 926 obesity ＋ 0. 879 language difficulties ＋ 2. 055 abdominal retraction ＋ 0. 829 dry tongue fur - l. 388 hemiplegia - 1. 739 scaly dry skin ＋ 0. 6478 tongu - 0.677 - 0.898 sluggish pulse - 6. 048 tongue state spit lane ＋ 0. 296. Its area under the ROC curve was 0. 720. Conclusion ： ①The dis- tribution of hypertension in patients with angina pectoris combined with cerebral infarction of TCM syndromes had statisti- cally significant difference. ②The top four syndromes which have high distribution rates of hypertension were： phlegm and blood stasis in collaterals （ 82.76% ）, wind phlegm （ 82.43% ）, phlegm retention syndrome （ 82.35% ） and hyper- activity of liver yang （82.35%）. ③In this study, we found symptoms such as obesity, language difficulties, abdominal retraction, dry tongue fur, hemiplegia, scaly dry skin, tongue, , sluggish pulse and tongue state spit lane,had relation- ship with hypertension in patients with angina pectoris combined with cerebral infarction, which has made contribution toestablish the discriminant model.