CAJ | 학술논문

目的：探讨高血压病的中医证型、危险因素及睡眠质量的关系，以期对高血压病患者的睡眠质量改善有所助益。方法选取本院心内科门诊的高血压病患者428例，运用匹兹堡睡眠质量指数(PSQI)量表进行评定，按其是否合并睡眠质量紊乱分为两组。同时重点询问病史(家族史、冠心病史、糖尿病史和脑卒中史)；测定身高(H)、体重(W)；检测空腹血糖(FPG)、餐后2 h血糖(2hPBG)，总胆固醇(CHOL)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)，尿酸(UA)，并进行血压的测定；计算体重(BMI)。结果①高血压合并睡眠质量紊乱组中医证型以阴虚阳亢证多见，其次为痰湿壅盛、肝火亢盛、阴阳两虚。②高血压合并睡眠质量紊乱组（A组）各指标相比较，A组的家族史、冠心病史、糖尿病史及收缩压明显高于高血压病不合并睡眠质量紊乱组(B组)P＜0.05；B组的BMI、TC、TG、FPG、2hPBG、HDL、LDL、UA与A组相比无显著性差异(P＞0.05)。③通过非条件Logistic回归分析，收缩压是睡眠紊乱发生的主要危险因素。结论①高血压合并睡眠质量紊乱组患者中医证型以虚实夹杂为主，以阴虚阳亢证多见。②高血压家族史、冠心病史、糖尿病史、高收缩压是高血压病合并睡眠质量紊乱的主要危险因素。
목적：탐토고혈압병적중의증형、위험인소급수면질량적관계，이기대고혈압병환자적수면질량개선유소조익。방법선취본원심내과문진적고혈압병환자428례，운용필자보수면질량지수(PSQI)량표진행평정，안기시부합병수면질량문란분위량조。동시중점순문병사(가족사、관심병사、당뇨병사화뇌졸중사)；측정신고(H)、체중(W)；검측공복혈당(FPG)、찬후2 h혈당(2hPBG)，총담고순(CHOL)、삼선감유(TG)、고밀도지단백(HDL)、저밀도지단백(LDL)，뇨산(UA)，병진행혈압적측정；계산체중(BMI)。결과①고혈압합병수면질량문란조중의증형이음허양항증다견，기차위담습옹성、간화항성、음양량허。②고혈압합병수면질량문란조（A조）각지표상비교，A조적가족사、관심병사、당뇨병사급수축압명현고우고혈압병불합병수면질량문란조(B조)P＜0.05；B조적BMI、TC、TG、FPG、2hPBG、HDL、LDL、UA여A조상비무현저성차이(P＞0.05)。③통과비조건Logistic회귀분석，수축압시수면문란발생적주요위험인소。결론①고혈압합병수면질량문란조환자중의증형이허실협잡위주，이음허양항증다견。②고혈압가족사、관심병사、당뇨병사、고수축압시고혈압병합병수면질량문란적주요위험인소。
Objective Study on relationship among syndromes of traditional Chinese medicine, risk factors and sleep quality of hypertension, which aims topromote the sleep qulity of hypertension. Methods Selecting 428people in essential hypertensive patients of cardiovascular internal medicine clinic,using the Pittsburgh sleep quality index(PSQI) scale to assess, and dividing into two groups based on the complication of sleep quality disturbance. At meanwhile, focusing on asking history (family history, coronary heart disease history, diabetes history and brain stroke history);determinating height(h)and weight(w);detecting fasting blood glucose (FPG), meal hou 2H blood glucose(2hPBG), lipid four items:total cholesterol(CHOL), glycerol three ester (TG), high density fat protein (HDL), low density fat protein (LDL), and uric acid (UA), and determinating blood pressure. Calculated weight (BMI)=W(kg)/[H(m)]2. Results ①The common TCM syndrome of the group of hypertension with sleep quality disturbance is Yang excess due to Yin deficiency, which followed by the syndromes of phlegm damp excess, liver-fire ascending, and deficiency of both yin and Yang.②All index phase comparison of Hypertension with sleep quality disturbance group (A group), such as family history, coronary heart disease history, diabetes history, and brain stroke history and the contraction pressure are all higher than hypertension disease without sleep quality disturbance Group (B group), P<0.05. There is no significant differences(P>0.05)of BMI, TC,TG, FPG, 2hPBG, HDL, LDL, and UA between Agroup and B group. ③Trough non-conditional Logistic regression analysis, systolic blood pressure is the main risk factor for sleep disorders. Conclusion ①TCM syndromes of hypertension patients with sleep quality disturbance group dominated by intermingled deficiency and excess, especially of Yin deficiency and Yang hyperactivity syndrome. ②History of family history of hypertension, coronary heart disease history, diabetes history, high systolic blood pressure are the major risk factors for hypertension with sleep quality disturbance.