社区老年高血压病患者的中医体质类型及相关危险因素分析

目的 探讨社区老年高血压病患者中医体质类型分布和相关危险因素，为高血压病的防治提供参考。方法 根据《中国高血压防治指南（2010）》，将5 582例社区老年志愿者分为高血压病组及非高血压病组。采用中医体质调查问卷，对其进行中医体质及危险因素分析。结果 5 582例老年人中，高血压病患者占55.2%，非高血压病者占44.8%；高血压病组平和质562例（18.2%），偏颇体质2 521例（81.8%），非高血压病组平和质467例（18.7%），其余共2 032例（81.3%）。进一步分析发现，高血压病组偏颇体质主要是痰湿质，非高血压病组偏颇体质主要是气虚质，两组之间体质分布差异具有统计学意义（P＜0.05）。Logistics回归分析结果显示：在高血压病与中医体质类型关系的模型中，痰湿质为独立危险因素；在高血压病与中医体质类型及相关因素关系的模型中，谷氨酸氨基转移酶（alanine transaminase, ALT）、痰湿质、同型半胱氨酸（homocysteine，Hcy）、血脂异常、年龄及血糖为危险因素。结论 本社区老年高血压病患者体质分布以偏颇体质多见，痰湿质、气虚质、阳虚质是较为常见的体质类型；ALT、痰湿质、Hcy、血脂异常、年龄及血糖是高血压病的危险因素。在社区慢性病管理中，根据不同中医体质类型制定相应的防治干预方案，积极调整偏颇体质，倡导健康的生活方式，加强对高血压病高危人群的干预，对社区老年高血压病的防治具有指导意义。

Traditional Chinese Medicine Constitution Types and Related Risk Factors in Elderly Hypertensive Patients in Communities

Objective To investigate the distribution of traditional Chinese medicine (TCM) constitution types and related risk factors in elderly hypertensive patients in communities, and to provide a reference for the prevention and treatment of hypertension. Methods According to The 2010 Chinese guidelines for the management of hypertension, 5 582 elderly volunteers in this community were divided into hypertension group and non-hypertension group. A TCM constitution questionnaire was used to analyze the distribution of TCM constitution types and related risk factors. Results Among the 5 582 volunteers, the patients with hypertension accounted for 55.2% and the volunteers without hypertension accounted for 44.8%. In the hypertension group, 562 (18.2%) had normal constitution and 2 521 (81.8%) had biased constitution; in the non-hypertension group, 467 (18.7%) had normal constitution and 2 032 (81.3%) had other constitution types. Further analyses showed that phlegm-dampness constitution was the main biased constitution in the hypertension group, while Qi-deficiency constitution was the main biased constitution in the non-hypertension group; there was a significant difference in the distribution of TCM constitution types between the two groups (P<0.05). The logistic regression analysis showed that in the model of hypertension with TCM constitution types, phlegm-dampness constitution was an independent risk factor, and in the model of hypertension with TCM constitutional types and related risk factors, alanine aminotransferase (ALT), phlegm-dampness constitution, homocysteine (Hcy), abnormal blood lipid levels, age, and blood glucose were risk factors. Conclusion Biased constitution is the main constitution type in the elderly hypertensive patients in this community, and phlegm-dampness constitution, Qi-deficiency constitution, and Yang-deficiency constitution are common constitution types. ALT, phlegm-dampness constitution, Hcy, abnormal blood lipid levels, age, and blood glucose are risk factors for hypertension. In the community-based management of chronic diseases, it is recommended to develop prevention and treatment regimens according to different TCM constitution types, actively adjust biased constitution, propose healthy lifestyle, and strengthen the intervention of the high-risk population of hypertension, in order to provide guidance for the prevention and treatment of elderly hypertension in communities.