高血壓中醫辨證分型之症狀分析

Symptom Analysis of Traditional Chinese Medical Syndromes Identification in Hypertension

目的：西藥治療，雖然可有效降低血壓，但患者的臨床症狀，如頭暈、倦怠、失眠、心悸、頻尿等未完全改善，急性事件如腦或心血管疾病的發生率並未顯著減少，因此本研究旨在探討高血壓中醫辨證分型之症狀分布規律，所得資料希望能夠有益於中醫師臨床上之參考。方法：本研究採橫斷式訪談調查法，以方便取樣宜蘭縣某兩所區域醫院，符合取樣標準之135名高血壓病患者為研究對象，採集症狀分類共有十五項，包括舌質、舌苔、脈象以及臨床症狀，以人數、百分比等方法，探討症狀分佈規律。結果：肝陽上亢型前三名症狀之人數、百分比，依序為口乾口苦（30人、18.5%）、急躁易怒（27人、16.7%）、便秘及舌紅（22人、13.6%；22人、13.6%）；陰虛陽亢型前三名症狀之人數、百分比，依序為苔少（20人、20.5%）、失眠（16人、16.3%）、心悸（12人、12.2%）；痰濕壅盛型前三名症狀之人數、百分比，依序為眩暈（30人、16.4%）、手足麻木及困倦乏力（29人、15.8%；29人、15.8%）、胸悶（25人、13.7%）；至於陰陽兩虛型前三名症狀之人數、百分比，依序則為苔白（14人、20.9%）、舌淡（12人、17.9%）、腰膝酸軟（9人、13.4%)。結論：眩暈以及口乾口苦出現人數最多，相反的，頭如裹與苔黃出現人數最少，可見症狀有主次之別，換言之，通過主次症狀之建立可為中醫辨證分型提供依據。

Objectives: The symptomatic treatment of Modern medicine is simply taking in the each single symptom, although effectively lower blood pressure, but the patient's clinical symptoms (dizziness, fatigue, insomnia, etc.) have not yet fully improved, acute events such as the brain or the incidence of cardiovascular disease has not been significantly reduced. Therefore, the purpose of this study aimed to investigate the symptom distribution of TCM symdromes classification in hypertension. We hope that the information of the study were able to benefit TCM doctors of clinical reference. Methods: On an interview on cross-sectional questionnaire survey, sampling I-lan County to facilitate the two regional hospitals, in line with standard sampling of 135 patients with hypertension for the study. There are fifteen categories collection of symptoms, including the tongue body, tongue coating, pulse and clinical symptoms. The number and percent were to explore the distribution of symptoms. Results: We found that the number and percentage of the top three symptoms on hypertension of hyperactivity of liver - yang sequentially as dry mouth with bitter mouth (30, 18.5%), irritability (27, 16.7%), constipation and red tongue body (22, 13.6%; 22, 13.6%). So as the top three symptoms on hypertension with yin deficiency and yang hyperactivity sequentially as less tongue coating (20, 20.5%), insomnia (16, 16.3%), palpitations (12, 12.2%), so as the top three symptoms on hypertension with abundant phlegm-dampness sequentially as vertigo (30, 16.4%), fatigue and numbness of hands and feet (29, 15.8%; 29, 15.8%), chest tightness (25, 13.7%), so as the top three symptoms on hypertension asthenia of both yin and yang sequentially as white tongue coating (14, 20.9%), pale tongue body (12, 17.9%), sored waist and knees (9 people, 13.4%). Conclusion: There were two symptoms of maximum number of occurrences such as dizziness and dry mouth with bitter mouth, while contrary head wrapped and yellow tone coating were as the minimum number of visible symptoms. It was visible that there were primary and secondary symptoms, in other words, it provided the basis of syndromes classification by through the establishment of primary and secondary symptoms in clinical medicine.