本文關鍵詞： 高血壓 節(jié)氣 血壓管理 中醫(yī)時間醫(yī)學　出處：《廣州中醫(yī)藥大學》2017年碩士論文　論文類型：學位論文

【摘要】：高血壓病是一種常見、多發(fā)病,也是心腦血管疾病最重要的危險因素,其并發(fā)癥嚴重威脅人民的健康。有效的控制血壓有助于減少心腦腎等靶器官的損害,降低心腦血管事件的發(fā)病率和死亡率。隨著經濟的發(fā)展,社會的進步,人們生活水平的提高,我國高血壓患病率呈上升趨勢,如何有效控制血壓成為目前醫(yī)學工作的熱點之一。目的:探討高血壓患者血壓波動與節(jié)氣、氣象因素的關系以及不同節(jié)氣(不同氣象條件下)高血壓患者心腦血管事件發(fā)生率。從中醫(yī)學"因時制宜"的角度闡釋血壓波動與節(jié)氣的關系,豐富中醫(yī)"因時制宜"調整高血壓患者血壓管理策略的理論。方法:本研究采用流行病學調查方法,臨床觀察對象為2016年1月至12月在廣東省中醫(yī)院心血管�？崎T診就診的原發(fā)性高血壓患者,要求觀察對象于二十四節(jié)氣當日測量血壓并記錄具體數(shù)值。血壓達標標準:一般患者血壓140/90mmHg。按此標準分別計算觀察對象二十四節(jié)氣日的血壓達標率并如實統(tǒng)計患者血壓波動情況。并選取廣州市氣象局發(fā)布的廣州市于二十四節(jié)氣日當日的地面氣象資料進行統(tǒng)計。數(shù)據(jù)記錄整理入庫,采用SPSS17.0軟件進行統(tǒng)計分析。收縮壓、舒張壓平均值與節(jié)氣關系的分析,組內比較采用方差分析或多個獨立樣本的非參數(shù)檢驗(Kruskal-Wallis H檢驗),收縮壓、舒張壓平均值以及收縮壓、舒張壓達標人數(shù)與氣象因素的關系,分別采用散點圖直觀展示,兩變量關系采用Pearson積矩相關分析。結果:1.血壓波動與節(jié)氣的關系不同節(jié)氣條件下,高血壓患者收縮壓和舒張壓平均值顯著不同(P0.05)。在小寒、大寒、冬至、大雪這四個節(jié)氣高血壓患者收縮壓、舒張壓平均值較高,其中,小寒時,患者血壓最高;大暑、小暑、立秋、夏至這四個節(jié)氣收縮壓、舒張壓平均值較低,其中,大暑時血壓平均值最低。在清明、芒種,舒張壓達標人數(shù)最多;而在小寒時,舒張壓達標人數(shù)最少。在立夏、大暑、立秋,收縮壓達標人數(shù)最多;從霜降-大寒,血壓達標人數(shù)逐漸減少,其中,大寒時,收縮壓達標人數(shù)最少。2.急診就診人次與節(jié)氣的關系該研究統(tǒng)計了在24節(jié)氣日當天,64例高血壓患者因急性心腦血管事件急診就診的次數(shù),結果發(fā)現(xiàn)在大寒、立春、處暑、秋分這三個節(jié)氣,高血壓患者因急性心腦血管事件急診就診次數(shù)較高,其中,大寒時最高。而在,白露、寒露、霜降這3個節(jié)氣急診就診人數(shù)較少。3.血壓波動與氣象因素的關系日平均氣溫與收縮壓平均值呈負相關(P0.01),r=-0.699;日平均氣溫與舒張壓平均值呈負相關(P0.01),r=-0.676;日平均氣溫與收縮壓達標人數(shù)呈正相關(P0.01),r=0.676;日平均氣溫與舒張壓達標人數(shù)無線性關系(P0.05)。日平均大氣壓與收縮壓平均值呈正相關(P0.05),r=0.468;日平均大氣壓與舒張壓平均值呈正相關(P0.05),r=0.436;日平均大氣壓與收縮壓達標人數(shù)呈負相關(P0.05),r=-0.414;日平均大氣壓與舒張壓達標人數(shù)無線性關系(P0.05)。日降水量、日平均相對濕度、日平均風速與收縮壓平均值、舒張壓平均值、收縮壓達標人數(shù)、舒張壓達標人數(shù)無線性關系(P0.05)。結論:本研究發(fā)現(xiàn)原發(fā)性高血壓患者的血壓達標率、急診就診人次與節(jié)氣、氣溫、大氣壓有一定的關聯(lián)性。在不同的節(jié)氣,原發(fā)性高血壓患者收縮壓、舒張壓平均值,以及血壓達標率、急診就診人次有所差異,高血壓患者血壓的波動容易受氣溫因素、氣壓因素的影響,結合氣溫的變化、大氣壓的情況調整降壓藥、降低高血壓患者急診就診率及預防心腦血管事件的發(fā)生具有一定的意義。本研究的樣本量小,所收集的數(shù)據(jù)有限,以后可引入高血壓慢病管理的大數(shù)據(jù),結合氣象學資料可得出更有說服力更科學的結論。
[Abstract]:Hypertension is a common disease, is also the most important risk factor for cardiovascular disease, the complications of a serious threat to people's health. Effective control of blood pressure can help reduce cardiovascular and kidney and other target organ damage, reducing cardiovascular events and mortality. With the development of economy, the progress of the society. The improvement of people's living standard, the prevalence of hypertension in China is rising, how to effectively control the blood pressure has become one of the focus of medical work. Objective: To investigate the fluctuation of blood pressure in patients with hypertension and the solar term, the relationship between meteorological factors and the different solar term (different meteorological conditions) the incidence of cardiovascular events in patients with hypertension. From the relationship between the traditional Chinese medicine "since" the perspective of blood pressure fluctuation and solar term, the rich Chinese medicine "time" to adjust the blood pressure of patients with hypertension management strategy theory. Methods: This study used epidemiological Methods of investigation, clinical observation object from January 2016 to December in Guangdong Province Traditional Chinese Medical Hospital cardiovascular clinic of primary hypertension patients, on the twenty-four day solar term blood pressure measurement and recording specific numerical observation object requirements. Blood pressure standard: blood pressure 140/ 90mmHg. patients according to the standards were calculated on the twenty-four solar term observation standard rate of blood pressure of patients and truthfully statistics the fluctuation of blood pressure. And choose to publish the Guangzhou Municipal Meteorological Bureau of Guangzhou City Statistics on meteorological data of twenty-four solar term on the day of data recording. Organize storage, using SPSS17.0 software for statistical analysis. The systolic blood pressure, diastolic blood pressure and the relationship between the solar term mean value analysis were compared by analysis of variance, multiple independent sample non parametric test (Kruskal-Wallis H test), systolic pressure, diastolic pressure and mean systolic blood pressure, diastolic blood pressure standard number The relationship with the meteorological factors, were used to plot visual display, two variables using Pearson product moment correlation analysis. Results: 1. blood pressure fluctuation and the different conditions of solar term solar term in patients with hypertension, systolic and diastolic blood pressure was significantly different (P0.05). In it, the winter solstice, but the contraction of patients with snow the four solar term high blood pressure, average blood pressure is higher, the cold, the blood pressure of patients with the highest; the great heat, slight heat, autumn, summer solstice of the four solar term systolic pressure, the diastolic blood pressure mean value is low, when the average value of blood pressure. The lowest heat in Qingming, grain in ear, diastolic blood pressure and in the largest number of standards; but when the diastolic blood pressure for at least the standard number. At the beginning of summer, autumn, great heat, the largest number of systolic blood pressure standard; from frost - chill, gradually reduce the number of blood pressure, the big chill, systolic blood pressure, the standard number of at least.2. emergency visits and solar term. The research department of statistics in the 24 solar term on the same day, 64 cases of patients with hypertension due to the number of acute cardiovascular events of emergency treatment, it was found at the beginning of spring, Chushu, autumnal equinox, the three solar term, due to acute cardiovascular events in patients with hypertension in the emergency department visits high, it was the highest. In the dew, cold dew, frost of the 3 solar term emergency fewer.3. blood pressure fluctuation and meteorological factors the relationship between daily mean temperature and mean systolic pressure was negatively correlated (P0.01, r=-0.699); the average daily temperature and average blood pressure was negatively correlated (P0.01, r=-0.676); the average daily temperature was positively correlated with systolic blood pressure (standard number P0.01, r=0.676); the average daily temperature and the standard number of no linear relationship between diastolic blood pressure (P0.05). The average pressure and the mean systolic pressure was positively correlated (P0.05), r=0.468; the average atmospheric pressure and average diastolic blood pressure values were positively correlated (P0.05), r= 0.436; average atmospheric pressure was negatively correlated with systolic blood pressure (P0.05), the standard number of r=-0.414; the average atmospheric pressure and diastolic blood pressure standard number no linear relationship (P0.05). Daily precipitation, daily average relative humidity, average wind speed and average systolic blood pressure, diastolic blood pressure average systolic blood pressure standard number. The standard number of no linear relationship between diastolic blood pressure (P0.05). Conclusion: This study found that the compliance rate of patients with primary hypertension and blood pressure, people in emergency department of air temperature, solar term, atmospheric pressure have certain relevance. In different solar term, essential hypertension patients with systolic blood pressure, diastolic blood pressure, average blood pressure rate of emergency visits vary, the blood pressure of hypertension patients easily affected by temperature fluctuation factors, pressure influence factors, combined with the change of temperature, pressure adjustment of antihypertensive drugs, reduce hypertension emergency treatment rate and prevention of cardiovascular and cerebrovascular events The occurrence of this disease has certain significance. The sample size of this study is small, and the data collected are limited. Later, big data of chronic disease management can be introduced. Combined with meteorology data, a more convincing and more scientific conclusion can be drawn.

【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R544.1

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