近10年我国不同地域原发性高血压证型分布及中药应用规律分析

目的:基于文献探讨近10年全国各大地区原发性高血压证型分布规律及中药用药规律。方法:检索2007年1月至2017年1月发表的有关原发性高血压的中医药研究文献,建立相关数据库,运用SPSS 17.0软件进行统计分析。结果:纳入统计的121594例原发性高血压患者的证型排序为:肝火亢盛证〉痰湿壅盛证〉阴虚阳亢证〉阴阳两虚证〉肝肾阴虚证〉瘀血阻络证〉痰瘀互结证〉气血亏虚证〉气阴两虚证〉痰热内扰证〉肝气郁结证〉脾肾两虚证;各地区证型分布皆以肝火亢盛证最多;华北、华南、华东、华中地区其次最多见的证型为痰湿壅盛证,西南、西北、东北地区其次以阴虚阳亢证最多见。31499例原发性高血压患者的中药使用频数从高到低依次为补虚药〉平肝息风药〉活血化瘀药〉清热药〉解表药〉利水渗湿药〉理气药〉化痰止咳平喘药〉安神药〉消食药〉收涩药〉祛风湿药〉止血药〉泻下药〉开窍药〉温里药〉化湿药;各地区中药使用频数以补虚药为首,华北、华南、西南、西北地区其次使用频数较高的为平肝息风药,东北、华东、华中地区其次使用频数最多的为活血化瘀药。结论:近10年全国原发性高血压证型多见于肝火亢盛证,中药治疗以补虚药最为常用。

Distributions of Traditional Chinese Medicine Syndrome in Primary Hypertension and Application Rule of Chinese Medicinals in Different Regions of China in the Last 10 Years

Objective:To study the distributions of traditional Chinese medicine(TCM) syndrome in primary hypertension and the application rule of Chinese medicinals in different regions of china in the last 10 years based on literature research. Methods:TCM literature on primary hypertension published from January2007 to January 2017 was searched to establish a database. Statistical analysis was performed using SPSS 17.0. Results:There were 121 594 patients with primary hypertension included for study of TCM syndrome. TCM syndrome types from the high frequency to the low frequency are listed as follows:overabundant liver-fire > excessive damp-phlegm > yin deficiency and yang hyperactivity > deficiency of both yin and yang > yin deficiency of liver and kidney > blood stasis blocking collaterals > intermingled phlegm and blood stasis > deficiency of qi and blood > deficiency of qi and yin > internal disturbance of phlegm heat > liver qi stagnation > deficiency of spleen and kidney. Overabundant liver-fire was the most common syndrome in each region;frequency of excessive damp-phlegm was the second in North China,South China,East China and Central China;frequency of yin deficiency and hyperactivity of yang was the second in the Southwest China,the Northwest China and the Northeast China. There were 31 499 patients with primary hypertension for study of the application rule of Chinese medicinals. Medicinals with the frequency from the high to the low are listed as follows:tonifying deficiency medicinals > calming liver and arresting wind medicinals > actviating blood and eliminating stasis medicinals > heat-clearing medicinals > relieving exterior medicinals > promoting urination and draining dampness medicinals > regulating qi medicinals >resolving phlegm and arresting cough and dyspnea medicinals > calming mind medicinals > promoting digestion medicinals > astringent medicinals > expelling wind and dampness medicinals > stopping bleeding medicinals > purgative medicinals > opening orifices medicinals > warming the internal medicinals > resolving dampness medicinals. Tonifying deficiency medicinals are of the highest frequency in each region.Calming liver and arresting wind medicinals was of the second frequency in the North China,South China,Southwest China and the Northwest China;activating blood and eliminating stasis medicinals was of the second frequency in Northeast China,East China and Central China. Conclusions:In the last 10 years,overabundant liver-fire syndrome was the most common type of primary hypertension in China,and the tonifying deficiency medicinals are the most common.